Bronchospasm in pt not on drug-
Neonate, infant < 6 month: Dose highly individualized. Keep serum theophylline levels < 10 mg/ml in neonate, 20 mg/ml in older infant. For PO, IV loading dose for pt < 6 month, 1 mg/kg PO, IV for each 2 mg/ml increase in theophylline level desired, then: Premature neonate (< 40 wk gestational age): 1 mg/kg q 12 h.
Neonate < 4 wk: 1-2 mg/kg q 12 h.
Infant 4-8 wk: 1-2 mg/kg q 8 h.
Infant > 8 wk-6 month: 1-3 mg/kg q 6 h. For PO loading dose, 6 mg/kg PO anhydrous theophylline, then:
Infant, child 6 month-9 yr: 4 mg/kg PO q 4 h × 3 doses; then 4 mg/kg PO q 6 h.
Child, adolescent 9-16 yr; young adult smokers: 3 mg/kg PO q 4 h × 3 doses; then 3 mg/kg PO q 6 h.
Infant, child 6 month-9 yr: 0.95 mg/kg/h (1.2 mg/kg/h anhydrous aminophylline) × 12 h; then 0.79 mg/kg/h (1 mg/kg/h anhydrous aminophylline).
Child 9-16 yr: 0.79 mg/kg/h (1 mg/kg/h anhydrous aminophylline) × 12 h; then 0.63 mg/kg/h (0.8 mg/kg/h anhydrous aminophylline).
Bronchospasm in pt on drug-
Child, adult: Each 0.5 mg/kg IV, PO (loading dose) increase plasma level by 1 mg/ml. Base dose on current theophylline level and lean body wt. In emergency: 2.5 mg/kg PO rapidly absorbed form if no signs of theophylline toxicity.
Bronchial asthma prophylaxis, bronchospasm of chronic bronchitis emphysema-
Individualize dose. Use peak plasma and trough levels to estimate dose. Therapeutic range: 10-20 mg/ml. Dose based on theophylline, anhydrous and lean body wt.
Child, adult: Rapidly absorbed form: 16 mg/kg or 400 mg PO qd (whichever less) divided q 6-8 h; increase by 25% q 2-3 day. Ext-rel: 12 mg/kg or 400 mg PO qd (whichever less) divided q 8-12 h; increase by 2-3 mg/kg qd q 3 day. Max qd dose:
Child < 9 yr: 24 mg/kg PO qd in divided doses.
Child 9-12 yr: 20 mg/kg PO qd in divided doses.
Adolescent 12-15 yr: 18 mg/kg PO qd in divided doses.
Adolescent = 16 yr, adult: 13 mg/kg PO or 900 mg PO qd in divided doses.
Apnea of prematurity-
Neonate: 4 mg/kg PO loading dose; then 1-1.5 mg/kg PO q 12 h. Start maintenance dose 12 h after loading dose.
Severe bronchospasm in CF-
Infant: 10-12 mg/kg IV qd. |