Aminophyllin and Salbutamol

Aminophyllin:

Theophylline's salt is aminophyllin. It is a smooth muscle relaxant for the respiratory system that causes bronchodilation.

Mechanism of action:

• It prevents adenosine receptors from contracting the bronchi, resulting in bronchodilation in the end.
• This prevents PDE from converting CAMP to AMP, which results in an increase in CAMP and bronchodilation.

Indication:

• Bronchial asthma
• COPD (chronic obstructive pulmonary disease)
• Chronic bronchitis
• Acute left ventricular failure with pulmonary oedema.

Dose:

• Adult: 100mg-300mg tid/qid (pc)

Contraindication:

• Heart disease, Pregnancy, lactation, pepticulcer.

Side effects:

• GI upset, Epigastric pain, nausea, vomiting, irregular heart beat, muscle cramps, convulsion, hypotension, insomnia, headache.

Nursing consideration:

• Aminophyllin has a low drug solubility, hence it should be taken with lots of water.
• The medication may cause gastritis, thus nurses are advised to take it after meals.
• Give the injection gradually, over 20 to 30 minutes.
• Aminophyllin is replaced by Theophyllin+Etophyllin (Asthma XR) in asthma.
• Consult a doctor right away if you experience hypersensitivity.
• It is advised that nurses keep a watchful eye on their patients' vital signs.

Salbutamol:

A short-acting, selective beta_{2} adrenergic receptor agonist, salbutamol.

Mechanism of action:

• It activates the beta_{2} adrenergic receptors, which are the main receptors in the smooth muscle of the bronchi.
• When beta_{2} receptors are stimulated, the enzyme adenyl cyclase is activated, which produces cyclic AMP from ATP.
• Additionally, it helps with early labor by relaxing the utrine muscle.

Indication:

• Reduction of bronchospasm symptoms brought on by reversible obstructive airway disease, chronic bronchitis, or bronchial asthma.

Dose:

• Adult: Reversible airways obstruction
• Tablet: 2-4mg tid or qid (Max 16mg/day)
• Child: 100 mcg - 150 mcg /kg/dose 6 to 8 hourly.
• Inhaler:
  • Adult: 2 puff 4 hourly as per required.
  • Child: Child over 6 years 100 mcg (1 puff) four hourly or as per required.
• Nebulizer:
  • Adult: One ml. diluted to 2 ml with sterile water or injection 4 to 6 hourly
  • Child: Less than 5 years: 0.5 ml diluted to 2 ml with sterile water for injection 4 to 6 hourly.
  • Above 5 years: Same as adult dose Pre term contraction: 2 to 4mg 6 to 8 hourly
• Doses of Rotacaps:
  • Adult acute bronchospasm: One or two Rotacaps as a single dose.
  • Child: One Rotacaps as a single dose
• Prophylaxis bronchospasm: 
  • Adult: One or two Rotacaps three or four times daily
  • Child: One Rotacaps three or four times a day

Contraindication:

• Heart disease, Throtoxicosis, MI

Side effects:

• Nervousness, Restlessness, Muscle tremors, Hypokalemia, hyperglycemia, Tachycardia is rare.

Nursing Consideration:

• Salbutamol can also be taken by nursing mothers.
• For the inhalation and pill forms of Rota, specific patient counseling is required.
• Two inhalers must be separated by one minute.
• Inform the doctors if the palpitation is severe.
• Consult a doctor if the tachycardia is severe.
• Please read the container's literature before using the Rota caps or inhaler.