아미노필린 / 테오필린

동물 종별 용량

투여 경로

금기

• Hypersensitivity to any xanthines (including theobromine or caffeine)
• Hypersensitivity to ethylenediamine (specific to aminophylline)

이상반응

• Nausea and vomiting
• Diarrhea
• Insomnia / Restlessness
• Polyphagia (increased appetite)
• Polydipsia and polyuria (increased thirst and urination)
• Tachycardia (rapid heart rate)
• Nervousness, excitability, and tremors (especially in horses)
• Diaphoresis (sweating in horses)
• Ataxia
• Seizures (in severe toxicity)
• Cardiac dysrhythmias (in severe toxicity)

약물 상호작용

• Phenobarbital · May decrease theophylline levels via hepatic enzyme induction.
• Fluoroquinolones (e.g., enrofloxacin, ciprofloxacin) · Can significantly increase theophylline levels. Consider reducing theophylline dose by 30% and monitor for toxicity.
• Macrolides (e.g., erythromycin, clindamycin, lincomycin) · Can increase theophylline levels.
• Cimetidine · Can increase theophylline levels by inhibiting hepatic metabolism.
• Ketamine · Concurrent use can cause an increased incidence of seizures.
• Halothane · Concurrent use may cause an increased incidence of cardiac dysrhythmias.
• Sympathomimetics (e.g., ephedrine, isoproterenol) · Toxic synergism; can lead to severe cardiac arrhythmias.
• Beta-blockers (non-selective, e.g., propranolol) · Can increase theophylline levels and antagonize bronchodilatory effects.
• Corticosteroids · Can increase theophylline levels.

모니터링

• Therapeutic efficacy (improvement in breathing/cough)
• Clinical signs of toxicity (GI upset, CNS stimulation, tachycardia)
• Serum trough levels at steady state (Target: >8-10 mcg/mL in small animals; do not exceed 15 mcg/mL in horses. Human therapeutic range is 10-20 mcg/mL)

과용량

Clinical signs of toxicity are usually associated with serum levels **greater than 20 mcg/mL** in humans, though dogs appear to tolerate higher levels. **Life-threatening signs:** * Tachycardia and severe cardiac arrhythmias * CNS effects including seizures and hyperthermia **Treatment is supportive:** * **Decontamination:** Empty the gut, administer activated charcoal and a cathartic if oral ingestion was recent. * **Seizures:** Maintain an adequate airway and treat with IV **diazepam**. * **Monitoring:** Continuous ECG monitoring for arrhythmias. Monitor and correct fluid/electrolyte imbalances. * **Symptomatic Care:** Hyperthermia may be treated with phenothiazines; severe tachycardia may be treated with **propranolol** if life-threatening.