Aminophylline injection

Use. Ethylenediamine hydrate is used in the manufacture of aminophylline and in the preparation of aminophylline injections. 

Certain issues of product instability may be resolved by formulation or careful selection of vehicle. Aminophylline injection, for example, is a solution of the drug in Water for Injections free from carbon dioxide, as the presence of this gas causes precipitation of the active. Similarly, promethazine injection is a solution of the active in Water for Injections free from dissolved air as the presence of oxygen would cause promethazine oxidation. Removal of these gases can be accomplished by prior boiling additionally the product may be packed under an atmosphere of nitrogen to eliminate oxygen from the head space in the ampoule. 

USE Solvent for casein, albumin, shellac, and sulfur emulsifier stabilizing rubber latex as inhibitor in antifreeze solns in textile lubricants. Pharmaceutic aid (aminophylline injection stabilizer),... 

Administration - The loading dose of aminophylline can be given by very slow IV push or, more conveniently, may be infused in a small guantity (usually 100 to 200 mL) of 5% Dextrose Injection or 0.9% Sodium Chloride Injection. Do not exceed the rate of 25 mg/min. Thereafter, maintenance therapy can be administered by a large volume infusion to deliver the desired amount of drug each hour. Aminophylline is compatible with most commonly used IV solutions. Oral therapy should be substituted for intravenous aminophylline as soon as adeguate improvement is achieved. 

The xanthines are readily absorbed by the oral and rectal routes. Although these agents can be administered by injection (aminophylline is a soluble salt of theophylline), intravascular administration is indicated only in status asthmaticus and apnea in premature infants. Intramuscular injection generally produces considerable pain at the injection site. 

Aminophylline Phyllocontin Oral extended-release oral rectal injection... 

The treatment of acute attacks of asthma in patients reporting to the hospital requires more continuous assessment and repeated objective measurement of lung function. For patients with mild attacks, inhalation of a -receptor agonist is as effective as subcutaneous injection of epinephrine. Both of these treatments are more effective than intravenous administration of aminophylline. 

Morphine Sulfate Morphine sulfate precipitates in alkaline media and drugs that are incompatible with it, including aminophylline, sodium salts of barbiturates, and phenytoin. Precipitate was found after 2 horns when morphine sulfate was formulated with acyclovir sodium.70 Incompatibilities also are reported with chlorpromazine hydrochloride injections containing chlorocresol. Admixture of morphine sulfate (1 mg/mL), doxorubicin in doxorubicin hydrochloride... 

Pethidine Hydrochloride Pethidine hydrochloride solutions are not compatible with barbiturates, aminophylline, morphine sulfate, sulfadiazine sodium, methicilline sodium, nitrofurantoin, phenytoin sodium, heparin sodium, sodium iodide, diethanolamine, sulfafurazol, acyclovir sodium, liposomal doxorubicin hydrochloride, frusemide, imipenem, and idarubicin. Visual incompatibilities are reported with mixtures of pethidine hydrochloride and cefoperazone sodium or mezlocillin sodium, nafcillin sodium and minocycline hydrochloride or tetracycline hydrochloride in 5% glucose injection.82 83... 

Aminophylline Aminophylline should not be mixed with acidic drugs, as it becomes precipitated if the pH of the final solution falls below pH 8. Mixture with glucose may increase the pH above 10 where proteins, such as insulin and erythromycin, are unstable. Some drugs that are incompatible with aminophylline include amiodarone, benzylpenicillin potassium, cisatracurium, ceftazidime, ceftriaxone, dobutamine, tetracycline hydrochloride, verapamil hydrochloride, warfarin sodium, and vitamin B and C injection. Alcohol-free theophylline should be stored in amber-colored containers maximum care must be taken to protect it against exposure to light.92-94... 

Amiodarone injection is incompatible with aminophylline, flucloxacillin, heparin, sodium bicarbonate, and sodium chloride solutions.99100... 

A 20-year-old man is hospitalized after an asthmatic attack precipitated by an upper respiratory infection and fails to respond in the emergency room to two subcutaneously injected doses of epinephrine. The patient has not been taking theophylline-containing medications for the past 6 weeks. He weighs 60 kg and you estimate that his apparent volume of theophylline distribution is 0.45 L/kg. Bronchodilator therapy includes a 5.6-mg/kg loading dose of aminophylline, infused intravenously over 20 min, followed by a maintenance infusion of 0.63 mg/kg per hour (0.50 mg/kg per hour of theophylline). Forty-eight hours later, the patient s respiratory status has improved. However, he has nausea and tachycardia, and his plasma theophylline level is 24 xg/mL. 

When theophylline (aminophylline) is given i.v., slow injection is essential in order to avoid transient peak concentrations which are equivalent to administering an overdose (below). 

In vitro studies with gentamicin and aminophylline have shown that the delivery of these drugs may be delayed substantially depending on the flow rate and injection site. These observations were confirmed with infusion of chloramphenicol succinate and tobramycin. These studies clearly have demonstrated that the variables of intravenous drug infusion systems (e.g., flow rate. 

Formulations of xanthines include intravenous injection, tablets and capsules. Examples of xanthine bronchodilators are theophylline and aminophylline. 

Radiographers who inject contrast agents must be trained in emergency treatment of severe adverse reactions and basic life support. The most severe adverse reaction is anaphylactic shock. This is treated as an emergency with adrenaline, atropine and oxygen. Antihistamines, aminophylline, salbutamol and corticosteroids may also be necessary. 

Sample preparation Add aminophylline, precipitate proteins with 0.8 M perchloric acid, inject an aliquot. 

Sample preparation Tablets. Weigh out powdered tablets containing 100 mg aminophylline, add 50 mL water, sonicate for 15 min, make up to 100 mL with water, mix, filter. Remove a 5 mL aliquot of the filtrate and add it to 10 mL 5 mg/mL dansyl chloride in acetone and 5 mL buffer, mix gently, let stand in the dark for 12 h, make up to 50 mL with acetone water 50 50, mix, inject an aliquot. Injections, oral liquids. Measure out an amoimt containing 100 mg aminophylline, make up to 100 mL with water, mix. Remove a 5 mL aliquot and add it to 10 mL 5 mg/mL dansyl chloride in acetone and 5 mL buffer, mix gently, let stand in the dark for 12 h, make up to 50 mL with acetone water 50 50, mix, inject an aliquot. (Prepare buffer by dissolving 550 mg anhydrous sodium carbonate in 300 mL water, add 300 mL acetone, mix.)... 

A study in 5 patients with stable ehronic active hepatitis B and 4 healthy subjects found that 20 hours after being given a single 9- or 18-million unit intramuscular injection of interferon (recombinant human interferon alfa A), the clearance of theophylline (given as intravenous aminophylline) was approximately halved (range 33 to 81%) in 8 of the 9 subjects. The mean theophylline elimination half-life was increased from 6.3 to 10.7 hours (1.5 to sixfold increases). In the healthy subjects the theophylline clearances were noted to have returned to their former values 4 weeks after the study. ... 

Ethylenediamine is used in numerous industrial processes as a solvent for casein or albumin, as a stabilizer in rubber latex and as a textile lubricant. It can be found in epoxy-resin hardeners, cooling oils, fungicides, and waxes. Contact dermatitis from ethylenediamine is almost exclusively due to topical medicaments. Occupational contact dermatitis in epoxy-resin systems is rather infrequent. Ethylenediamine can cross react with triethylenetetramine and diethylenetriamine. Ethylenediamine was responsible for sensitization in pharmacists handling aminophylline suppositories, in nurses preparing and administering injectable theophylline, and in a laboratory technician in the manufacture of aminophylline tablets. 

Injection of Aminophylline, B.P. Usually a 2-5 per cent solution in water for injection. 

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