Doses & Administrations:
Oral:
Adult:100-300 mg 3-4 times daily after food.
Pediatric:6mg/kg every 12 hours increased to 12 mg/kg.
For better dose range in children see theophylline.
Parenteral :Adult : Slow I/V (over 20 min ) 250 - 500 mg i.e (5 mg/kg) when necessary.
Maintenance if required, in patients notpreviously treated with xanthines
500 mcg/kg/hour slow I/V.
Pediatric :
Neonates : 0.2mg/kg/hr
6 weeks-6 months: 0.5mg/kg/hr
6 months - 1 yr : 0.6-0.7mg/kg/hr
1 to 9 years : 1-1.2 mg/kg/hour
9-12years and young adult smokers: 0.9mg/kg/hr
12 years healthy non smokers : 0.7mg/kg/hr
Adverse Effects:Nausea, vomiting, anorexia, diarrhea, rectal irritation, dizziness, headache, insomnia, convulsion,severe depression, tachycardia, circulatory failure and life threatning ventricular arrythmia.
Warnings / Precautions:Aminophylline should be used with caution in patients with severe heart, kidney, liver diseases, hyperthyroidism, congestive heart failure (CHF) or peptic ulcer. It should be used with caution in neonates and in elderly persons.
Mechanism of Action:Theophylline has two distinct actions in the airways of patients with reversible obstruction: smooth muscle relaxation (i.e., bronchodilation) and suppression of the response of the airways to stimuli (i.e., non-bronchodilator prophylactic effects). While the mechanisms of action of theophylline are not known with certainty, studies in animals suggest that bronchodilatation is mediated by the inhibition of two isozymes of phosphodiesterase (PDE III and, to a lesser extent, PDE IV) while non-bronchodilator prophylactic actions are probably mediated through one or more different molecular mechanisms, that do not involve inhibition of PDE III or antagonism of adenosine receptors. Some of the adverse effects associated with theophylline appear to be mediated by inhibition of PDE III (e.g., hypotension, tachycardia, headache, and emesis) and adenosine receptor antagonism (e.g., alterations in cerebral blood flow).
Theophylline increases the force of contraction of diaphragmatic muscles. This action appears to be due to enhancement of calcium uptake through an adenosine-mediated channel.
Sources
http://www.globalrph.com/pulmonary_theophylline.htm
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