How does aminophylline poison do?
summary
Aminophylline, if patients feel unwell, should immediately go to the hospital for diagnosis and treatment, as a treatment of bronchial asthma, asthmatic bronchitis, obstructive emphysema and acute cardiac insufficiency and other diseases of the drug, is widely used in clinical. However, the effective blood concentration of aminophylline is close to that of poisoning, and the range of effective blood concentration is 10-20 μ G / ml, if higher than 20 μ In severe cases, it can cause respiratory and cardiac arrest to death. Today, let me learn how to deal with aminophylline poisoning?.
How does aminophylline poison do?
First: when aminophylline is combined with antibacterial drugs, attention should be paid: aminophylline releases theophylline in the body, and theophylline can be metabolized by liver cytochrome P450 isoenzymes CYP3A4 and CYP1A2. Some antibacterial drugs affect the metabolism of theophylline by affecting the action of P450 isoenzymes, so as to increase or decrease the blood concentration of theophylline.
Second: the interaction between aminophylline and other drugs: phenobarbital and phenytoin sodium are drug enzyme inducers, which can accelerate the metabolism of theophylline when combined, so the dosage of theophylline should be adjusted. Landay et al. Found that the clearance rate of theophylline was 33. 3% faster than that of theophylline alone ± Therefore, the dosage of theophylline should be increased by 30%. Phenytoin sodium combined with theophylline can accelerate the clearance rate of theophylline about 2 times after 10-15 days, so the dosage should be increased by 15-20%.
Third: smoking can also affect the metabolism of aminophylline, which has the antiasthmatic effect of relaxing bronchial smooth muscle. Smoking can accelerate the metabolism and excretion of theophylline, shorten its half-life and reduce its efficacy.
matters needing attention
1. Intravenous injection should be reduced as much as possible. If intravenous injection is necessary, the dripping rate should be controlled, not too fast. There are reports of death. Aminophylline is usually administered intravenously in patients with acute asthma or persistent state of asthma, which can quickly control symptoms. Aminophylline is usually administered with its loading dose first, and then the effective dose is maintained. Intravenous injection, 0.125-0.25 g once, 0.5-1 g a day, 0.25 g each time, diluted to 40 ml with 50% glucose injection, the injection time should not be less than 10 min. The purpose of diluting with hypertonic glucose is to increase the resistance of injection and keep the injection speed from being too fast. Intravenous drip, 0.25-0.5 g once, 0.5-1 g a day, diluted with 5% - 10% glucose injection, then slowly drip. 2. Patients with significantly low blood pressure or acute myocardial infarction are forbidden. 3. Aminophylline intravenous preparation can not be exposed to air, which will lead to oxidation, yellowing and drug failure. 4. Aminophylline is a strong alkaline drug. Intravenous administration of aminophylline can cause local irritation and local swelling and pain after leakage. It is necessary to deal with it in time to prevent skin necrosis. It is necessary to pay attention to observation during intravenous administration.
