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[Determination of the optimal dose of aminophylline in children with severe asthmatic attacks]
Insights
Aminophylline is effective for severe childhood asthma attacks when given at a dose of 7 mg/kg. Lower doses of aminophylline (theophylline) did not provide adequate therapeutic response or serum concentrations in children.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Context:
- Severe asthma exacerbations in children require effective bronchodilator therapy.
- Aminophylline, a theophylline derivative, is used for managing asthma.
- Optimizing dosage and administration is crucial for therapeutic efficacy and safety.
Purpose:
- To evaluate the therapeutic effect of aminophylline in children with severe asthmatic attacks.
- To determine the appropriate dosage, administration, and serum concentrations of aminophylline.
- To compare the efficacy of different aminophylline doses in pediatric patients.
Summary:
- A study involving 24 children with severe asthma compared three aminophylline dosage groups (7 mg/kg, 5 mg/kg, and 4 mg/kg).
- Optimal therapeutic response and serum theophylline concentrations were achieved only in the 7 mg/kg group.
- Lower doses resulted in inadequate response and required repeated administration; mild hyperglycemia was observed in most patients.
Impact:
- The findings support aminophylline, administered at an adequate dose (7 mg/kg), as a primary treatment for severe asthma attacks in children.
- This research aids in establishing evidence-based dosing guidelines for aminophylline in pediatric asthma management.
- Understanding optimal aminophylline dosing can improve treatment outcomes and reduce the need for repeat interventions in pediatric severe asthma.
Abstract:
The therapeutic effect of aminophylline in children having severe asthmatic attacks with a special emphasis on an appropriate dose, adequate administration and measurement of serum aminophylline concentrations is presented. The study group consisted of 24 patients with severe asthmatic attacks. The patients were assigned to three groups according to the dosage of aminophylline administered. Patients in Group 1 received a dose of 7 mg/kg body weight, those in Group 2 5 mg/kg body weight and those in Group 3 (previously treated with theophylline) 4 mg/kg body weight. For each patient, clinical and laboratory parameters were followed. The results demonstrated that adequate therapeutic response and optimal serum theophylline concentrations were achieved only in Group 1. Patients in which lower doses of aminophylline were employed (Group 2 and Group 3) showed neither the adequate therapeutic response not did achieve the adequate serum theophylline concentrations, and administration of aminophylline had to be repeated. In the majority of patients, mild hyperglicemia was noticed. The mechanism and the sequence of events how it occurred was not determined. In conclusion, this data show that aminophylline, if administered in an adequate dose, is a drug of choice in the treatment of children with severe asthmatic attacks.