Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Comparison between adverse effects of low and usual doses of intravenous aminophylline

정주 아미노필린의 투여 농도에 따른 부작용에 관한 연구

  • Kim, Bok Ki (Department of Pediatrics, School of Medicine, Inha University) ;
  • Lim, Dae Hyun (Department of Pediatrics, School of Medicine, Inha University) ;
  • Ahn, So Hyun (Department of Pediatrics, School of Medicine, Inha University) ;
  • Kwak, Jong Hoon (Department of Pediatrics, School of Medicine, Inha University) ;
  • Kim, Jeong Hee (Department of Pediatrics, School of Medicine, Inha University) ;
  • Son, Byong Kwan (Department of Pediatrics, School of Medicine, Inha University)
  • 김복기 (인하대학교 의과대학 소아과학교실) ;
  • 임대현 (인하대학교 의과대학 소아과학교실) ;
  • 안소현 (인하대학교 의과대학 소아과학교실) ;
  • 곽종훈 (인하대학교 의과대학 소아과학교실) ;
  • 김정희 (인하대학교 의과대학 소아과학교실) ;
  • 손병관 (인하대학교 의과대학 소아과학교실)
  • Received : 2008.09.12
  • Accepted : 2008.11.14
  • Published : 2009.04.15
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Abstract

Purpose : Some patients develop side effects from theophylline even at low serum concentrations. We designed a prospective study to evaluate the side effects of theophylline. Methods : A Prospective, controlled trial study was conducted. The low-dose group received an intravenous continuous aminophylline dose of 5 mg/kg/day on the first day and subsequently 10 mg/kg/day on the following two days. The usual-dose group received 10 mg/kg/day for three days and the control group received normal saline for three days. Heart rate, respiratory rate, serum concentration of theophylline, and four adverse events (irritability, sleep disturbance, jitter, and vomiting) were checked at the time of admission and at 2, 12, 24, 48, and 72 h after the start of aminophylline infusions. Results : Nine patients out of 37 in the low-dose group and six of 21 in the usual-dose group dropped out because of uncontrolled irritability. The serum concentrations of theophylline in dropouts ($3.68{\pm}1.93$ ig/mL) and participants ($4.47{\pm}2.45$ ig/mL) were not significantly different. Irritability was a more frequent side effect in the usual-dose group at 12 h, but there was no difference between the low-dose and usual-dose groups in terms of vomiting, sleep disturbance, and jitter. Most of the severe adverse effects were observed in children below two years of age. Conclusion : Some patients dropped out regardless of the initiating aminophylline dose, especially patients under the age of two years.

목 적 : 아미노필린을 낮은 농도(5 mg/kg/day)에서부터 점진적으로 증량할 때와 일상 용량(10 mg/kg/day)으로 시작할 때 나타나는 부작용을 비교하고자 하였다. 방 법 : 2007년 3월부터 2008년 1월까지 인하대병원 소아과에 호흡기질환으로 입원한 환아들을 대상으로 정주 아미노필린의 투여 용량을 달리하여, 투여 후 3일간의 활력 징후, 부작용 및 혈중 농도를 조사하였다. 결 과 : 저용량군 37명, 일반용량군 21명, 대조군 9명이었다. 저용량군과 보통용량군 간의 입원 시 연령, 신체활력징후, 혈액검사의 차이는 없었다. 경련과 같은 심각한 부작용은 없었다. 저용량군에서는 9명(24.3%)이 보챔, 수면장애로 아미노필린 사용을 중단하였으며, 일반용량군에서는 6명(28.6%)이 아미노필린 투여를 중단하였고, 투여를 중단한 경우의 혈중 농도($(3.68{\pm}1.93{\mu}g$/mL)와 중단 없이 사용한 군의 혈중농도($(4.47{\pm}2.45{\mu}g$/mL)의 차이는 없었다. 투여를 중단하게 된 경우는 대부분 2세 미만의 환자에서 발생하였다. 결 론 : 저자들은 급성 천식환자에서 정주 아미노필린의 부작용은 초기 투여용량과는 관계가 없다고 생각하며, 본 연구에서 사용한 용량보다 고용량 투약에 따른 연구 및 연령에 따른 연구가 필요할 것으로 생각한다.

Keywords

Acknowledgement

Supported by : 인하대학교

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