Aminophylline was administered intravenously in infants with apnoea, in a loading. Background apnea of prematurity aop usually occurs in neonates with. However, clinicians show indecision in choosing the right agent for apnea of prematurity in most of the developing countries. Aminophylline dissociates into theophylline, which is a xanthine derivative. Factors affecting the efficacy and safety of aminophylline. Administer via infusion pump to ensure accurate dosage. Prospective evaluation of two dosing equations for. The listing is as shown below together with the other respiratory tract medicines listed. The duration, dosage and route of administration of doxapram together with its efficacy was evaluated in two dutch neonatal intensive care. Preterm infants treated with an oral loading dose of. Background current dosage regimen of aminophylline is similar in both appropriate for gestational age aga and small for gestational age sga preterm neonates. The term apnea refers to the cessation of breathing for more than 1520 seconds or less than 15 seconds if it is accompanied by cyanosis or bradycardia 1.
It may occur repeatedly in preterm babies born before 34 weeks gestation. A few studies have been carried on preventive drugs for apnea of preterm neonates. Aminophylline injection norphyl, phyllocontin, truphylline is a bronchodilator injection drug used for the management of acute worsening of asthma or copd. However, developing countries like india has significant proportion of growth restrictedsga babies. Apnea is a pause in breathing of greater than 20 seconds. Present study aimed to compare rate of mortality and survival with normal neurodevelopment outcome at 18 to 24 months of corrected age, between caffeine and aminophyllinetreated infants for apnea of prematurity. The efficacy of both the drugs is similar but caffeine has lesser side effects and better dosage convenience, as it requires once daily administration compared to thrice daily dosing of aminophylline. Caffeine versus aminophylline for the prevention of apnoea of prematurity in a teaching hospital in south africa.
Clinical pharmacology of caffeine citrate in preterm infants. Review aminophylline background the current th edition of the who model essential medicines list dated april 2003 includes aminophylline on the complementary list. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Comparative efficacy and safety of caffeine and aminophylline for. Pharmacologic effects of theophylline in the newborn jaci. Longterm neurodevelopment outcome of caffeine versus. Patients should report any increase in methylxanthineinduced side effects, like tremor, nausea, or vomiting promptly. Its main action is bronchial smooth muscle relaxation, thereby relieving. P62 population pharmacokinetic study of aminophylline in. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6 apr 2020, wolters kluwer updated. The effectiveness of aminophylline in the treatment of apnea of prematurity was evaluated in premature infants mean birthweight, 1. Hence, there is a need to develop appropriate dosage.
Theophylline is an effective respiratory stimulant for apnea of prematurity. There is some evidence that caffeine is as effective as theophylline in the shortterm for reducing apnea in premature babies, is better tolerated and is easier to give. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6 apr 2020. It is used as a bronchodilator and also as an antidote to dipyridamole toxicity. For therapy unresponsive apnoea doxapram is often prescibed in preterm neonates. Get a printable copy pdf file of the complete article 503k, or click on a. Comparative efficacy and safety of caffeine and aminophylline for apnea of prematurity in preterm.
Caffeine versus aminophylline for the prevention of apnoea. Aminophylline definition of aminophylline by medical. Apnea of prematurity defined as cessation of breathing that lasts for more than 15 seconds and is accompanied by hypoxia or bradycardia occurs in at least 85 percent of infants who are. Guideline for caffeine use in preterm infants introduction apnoea of prematurity is defined as periods over 20 seconds of apnoea or less if associated with bradycardia and desaturation. Apnea was recorded by direct observation in combination with impedance monitoring. Doxapram use for apnoea of prematurity in neonatal.
Treatment of apnea of prematurity with aminophylline. Prophylactic aminophylline for prevention of apnea at higherrisk. The prophylactic effect of aminophylline on apnea was investigated in premature. Drug levels in excess of 20 mcgml are associated with toxicity. Apnoea of prematurity is treated with noninvasive respiratory therapy and methylxanthines. Pdf prophylactic aminophylline for prevention of apnea at higher.
Treatment of apnea of prematurity with aminophylline american. Aminophylline dosing in the treatment of apnea of prematurity a commentary. Pdf prophylactic theophylline infusion for prevention of. Prophylactic aminophylline for prevention of apnea at.
However, recently published data suggest that this benefit is no longer associated with a significantly improved rate of survival without disability in children who were of very low birth weight and assessed at age 5 years. We identified preterm infants who received aminophylline infusion for apnea. Rapid administration may cause chest pain, dizziness, hypotension, tachypnea. Reliability of salivary theophylline in monitoring the. Caffeine versus theophylline for apnea in preterm infants. If aminophylline is coadministered with fluvoxamine, the aminophylline daily dosage should be reduced and plasma aminophylline concentrations should be monitored. Aminophylline may enhance the sensitivity of the myocardium to, and the toxic.
Outcome concerning shortterm safety and neonatal morbidity were evaluated. Therapeutic monitoring of theophylline in newborns with apnea. This study aimed to assess the safety and prophylactic effects of aminophylline on the incidence of apnea in premature neonates. Administration may be oral, intramuscular, intravenous, or rectal. Pdf rectal aminophylline in the management of apnoea of. Few concerns we read with interest the recent paper by shivakumar, et al. Aminophylline administration is as effective as caffeine for apnea of prematurity both in aga and sga category, and can continued to be used in resourcepoor setting. To evaluate the reliability of salivary levels of theophylline in monitoring therapy of apnoea of prematurity. Dosage schedule for intravenous aminophylline in apnoea of prematurity, based on pharmacokinetic studies. Dosage schedule for intravenous aminophylline in apnoea of prematurity, based on. Concurrent with the discovery of the utility of pge 1 in ductaldependent neonates, aminophylline was reported to be a useful respiratory stimulant in premature neonates with apnea of prematurity. Side effects were related to the plasma theophylline concentration and were not. Therapeutic plasma levels range from 1015 mcgml forasthma and 614 mcgml for apnea of prematurity.
Background apnea of prematurity aop usually occursin neonates with a gestational age adults theophylline is a bronchial smooth muscle relaxant and bronchodilator. Infants on aminophylline experienced less apnea spells in 47 days of. Guideline for caffeine use in preterm infants author. Apnea of prematurity may be associated with significant neonatal morbidity and mortality.
Aminophylline dihydrate at an initial dose of 10 mgkg body weight. Dosage schedule for intravenous aminophylline in apnoea of. That being said, caffeine remains the preferred drug of choice to treat the apnea of prematurity. Indication intravenous aminophylline may be used for acute exacerbation of chronic obstructive lung. The dosage of theophylline used in the present study was that recommended for optimum bronchodilator effect. Prospective evaluation of two dosing equations for theophylline in premature infants varsha bhattmehta, pharm. Factors affecting the efficacy and safety of aminophylline in. Pdf aminophylline dosing in the treatment of apnea of. Intravenous iv theophylline is only available as aminophylline, which is a prodrug of theophylline. Rectal aminophylline in the management of apnoea of prematurity. Conventional therapy includes oxygen supplementation in conjunction with administration of theophylline or caffeine to increase respiratory drive. Shivakumar m1, jayashree p, najih m, lewis les, bhat y r, kamath a, shashikala. Both caffeine and aminophylline are used for reducing apneic spells in preterm babies with apnea of prematurity. Apnea of prematurity aop is the most common clinical condition of premature newborns, potentially leading to multiple organ dysfunction and affecting the mental development of neonates.
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