Aminophylline versus caffeine citrate for apnea and bradycardia prophylaxis in premature neonates

Larsen, P. N.; Brendstrup, L; Skov, Liselotte; Flachs, Helga

doi:10.1111/j.1651-2227.1995.tb13649.x

Cited by 35 publications

(15 citation statements)

References 13 publications

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“…[109,110] Significant adverse effects reported by these studies consist of increased tachycardia and gastrointestinal disturbances with theophylline. [105][106][107][108] Most authors prefer caffeine due to its ease of administration (once daily) and wider margin of tolerability, with fewer cardiovascular adverse effects.…”

Section: Comparative Trialsmentioning

confidence: 99%

“…There are a number of comparative studies of aminophylline or theophylline, and caffeine [105][106][107][108] or doxapram [109,110] (table III). Studies comparing theophylline and caffeine have found them to be of comparable efficacy, although the administration regimens and routes of administration vary widely, especially for theophylline.…”

Section: Comparative Trialsmentioning

confidence: 99%

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Treatment of Apnea of Prematurity

Bhatt‐Mehta

Schumacher

2003

Pediatric Drugs

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In the last decade, knowledge regarding the neurodevelopment and functional aspects of the respiratory centers during postnatal maturation has increased substantially. However, an increase in such knowledge has not provided a basis for change in practice. The diagnosis of apnea of prematurity (AOP) is one of exclusion. All causes of secondary apnea must be ruled out before initiating treatment for AOP. Treatment will depend on the etiology as well as effectiveness and tolerability of the treatment by the patient. The primary goal of any treatment of AOP is to prevent the frequency of apnea lasting >20 seconds, and/or those that are shorter, but associated with cyanosis and bradycardia. The clinical management of AOP is not much different today than it was two decades ago, with pharmacologic and nonpharmacologic treatment options remaining the mainstay of therapy. Methylxanthines are still the most widely used pharmacologic agents. Due to the wider therapeutic index of caffeine and ease of once daily administration, it should be the preferred agent. Doxapram, or nonpharmacologic treatment measures such as nasal continuous positive airway pressure, may be considered in infants who are unresponsive to methylxanthine treatment alone. Treatment should be continued until there is complete resolution of apnea, and for some time thereafter. The choice of method for weaning treatment remains one of individual physician preference. Discharge from hospital after apnea requires close monitoring and some infants will require home apnea monitors. The decision to provide a home apnea monitor should be individualized for each patient, depending on the effectiveness of treatment and clinical response.

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Section: Comparative Trialsmentioning

confidence: 99%

Section: Comparative Trialsmentioning

confidence: 99%

Treatment of Apnea of Prematurity

Bhatt‐Mehta

Schumacher

2003

Pediatric Drugs

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“…Our randomized study was carried out in two centres, but the policies regarding weaning and extubation were very similar. Although in one institution theophylline or caeine was used and in the other aminophylline, the two medications have been shown to have similar ecacy, at least in treating infants with apnoea [9]. Two dierent forms of CPAP were used, but although it has been claimed that the binasal system has superior function [8], this has been disputed [10].…”

Section: Discussionmentioning

confidence: 98%

Elective use of nasal continuous positive airways pressure following extubation of preterm infants

Dimitriou¹,

Greenough²,

Kavvadia³

et al. 2000

Eur J Pediatr

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“…Similarly, a study found similar efficacy of aminophylline and caffeine in preventing AOP, although their aminophylline dose was lower than that of our study. 8 Aminophylline is from the same family of drugs as caffeine and has a similar mechanism of action, i.e., affecting the same adenosine receptors (adenosine A 1 , A 2A and A 3 receptors). 9,10 Aminophylline is metabolized by the body into several active forms, but due to incomplete liver development in premature infants, several metabolites from aminophylline cannot be activated.…”

Section: Discussionmentioning

confidence: 99%