QuestionSBA
QuestionChoice
This would be useful as a baseline as aminophylline is metabolised hepatically. However routine monitoring is not necessary
34347
c
Liver function tests
QuestionChoice
This patient is at risk of hypokalaemia due to repeated salbutamol nebulisers and commencement of an aminophylline infusion. Renal function should be monitored
34345
a
Urea and electrolytes
QuestionChoice
Intravenous magnesium is commonly given for severe acute exacerbations of asthma and levels may be monitored during treatment. However it is not being used here
34349
e
Serum magnesium
QuestionChoice
This would be a useful marker of beneficial effects of the treatment rather than adverse effects
34348
d
Respiratory rate
QuestionChoice
This would be a useful marker of beneficial effects of the treatment rather than adverse effects
34346
b
Bedside spirometry
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2812
Aminophylline side effects
Topic
9
Internal Medicine
6880
Case Presentation: A 19 year old man presents to A&E with chest pain and shortness of breath. **PMH** asthma, has had 3x previous A&E attendances for acute exacerbations and 1x hospitalisation stay. **DH** salbutamol 200 micrograms inhaler PRN, beclomethasone with formoterol (Fostair NEXThaler) 100/6 micrograms powder inhaler 2 puffs BD. Allergic to pollen and cat fur – exacerbates asthma.


**O/E**

Visibly short of breath with tripoding and use of accessory neck muscles. Sweaty. Peripherals warm and well-perfused. HR 103, RR 29, BP 129/68, O2 100% 15L reservoir mask. Widespread polyphonic wheeze on chest auscultation.

**Investigations**

CXR: No consolidation or pneumothoraces

PEFR: 45% of normal predicted value

He has been given back to back salbutamol and ipratropium nebulisers and is being started on an aminophylline infusion.

Question: Select the most appropriate option to monitor for adverse effects of this treatment.
a