Ketamine Aminophylline

Hirshman, C. A. et al., Ketamine-aminophylline-induced decrease in seizure threshold, Anesthesiology, 56(6) 464-467, 1982. 

Cardiac arrhythmias can develop during the concurrent use of halothane and aminophylline but this seems less likely with isoflu-rane. One report attributes seizures to an interaction between ketamine and aminophylline. Supraventricular tachycardia occurred in a patient taking aminophylline when pancuronium was given. Isolated cases suggest that the effects of pancuronium, but not vecuronium, can be opposed by aminophylline. 

Over a period of 9 years, tachycardia and extensor-type seizures were observed in 4 patients taking theophylline or aminophylline, who were initially anaesthetised with ketamine, and later with halothane or enllurane." Based on subsequent study in mice, the authors attributed the seizures to an interaction between ketamine and theophylline or aminophylline, and they suggest that the combination should perhaps be avoided in some, or antiseizure premedication be given to patients at risk. However, these cases come from one isolated report. Note that, in mice, ketamine had no effect on aminophylline-induced seizures. ... 

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