Page 1 of 2: Precaution for Aminophylline

spatil · Credits: 2263 My Scrapbook

What precautions should be taken before injecting aminophylline to asthma patient ?

moawia · Credits: 421 My Scrapbook

*Particular caution in dose administration must be exercised in patients with a history of peptic ulcer since the condition may be exacerbated
*Patients with a history of hypersensitivity to aminophylline or theophylline should not be treated with AMINOPHYLLIN.
*Do not administer AMINOPHYLLIN with other xanthine preparations.
Administration of ephedrine or other sympathomimetic drugs to patients already *on treatment with AMINOPHYLLIN may result in toxic synergism.
*Use with caution in patients with severe cardiac disease, hypertension, hyperthyroidism, acute myocardial injury, cor pulmonale, severe hypoxemia, hepatic impairment, or alcoholism, and in the elderly (especially males) and in neonates.

spatil · Credits: 2263 My Scrapbook

I have read somewhere that we should rule out that it is cardiac asthma. What is it?

doctor82 · Credits: 580 My Scrapbook My Reading List 1 Books

Cardiac asthma is an asthmatic attack due to bronchoconstriction caused by pulmonary congestion and failure of the left ventricle. Pulmonary edema as in conditions like mitral stenosis produces symptoms similar to bronchial asthma. This topic is dealt in detail in text books of internal medicine.

spatil · Credits: 2263 My Scrapbook

How can we rule out possibility of cardiac asthma?

doctor82 · Credits: 580 My Scrapbook My Reading List 1 Books

Differentiation between bronchial asthma and cardiac asthma is clinical and is to be ideally discussed in an internal medicine forum.

But in short Cardiac asthma differs from bronchial asthma by

-Evidence of a causative lesion for pulmonary edema – e.g. Mitral Stenosis and all its causes
-No history of allergy
-Negative family history
-Occurs usually in early hours of night
-Profuse pinkish frothy expectoration
-Pulsus alternans
-Presence of hypertension

spatil · Credits: 2263 My Scrapbook

Thnx. I have not started with my 3rd yr yet & I haven't studied medicine seriously in 2nd yr. Will u please mind to to report relevant clinical findings of cardiac asthma ( in cases where patient is in state not to give history if there is little time to check all the things)

dr4jc · Credits: 4396 My Scrapbook

hey in cardiac asthma also aminophylline may be helpful since phosphodiestrase inhibitors increase the force of contraction rite?... so I dont think it would b a contraindication as such unless youre already giving milrinone for heart failure...

doctor82 · Credits: 580 My Scrapbook My Reading List 1 Books

Hi Spatil,

That was everything I knew on that topic. Clinical diagnosis is made only after a clinical examination and a history even in the emergency settings. Only the time duration is limited and we need to ask relevant questions.
So if a patient is complaining of dyspnoea and is a known case of a heart disease like or a history suggestive of it like say rheumatic fever, suspicion always goes to pulmonary edema rather than an adult onset bronchial asthma.

doctor82 · Credits: 580 My Scrapbook My Reading List 1 Books

Hi dr4jc,

Yah, aminophylline is an inotropic and I don't believe that it is contraindicated. But it is not indicated as well.

Treatment actually consists of treating the cause, decreasing the venous return, diuretics, nitrates and rarely inotropics.

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