Why is aminophylline contra-indicated in peptic ulcer patients ?

     Generally, aminophylline is a type of medication used in treatment of respiratory distress and respiratory failure, It belongs to the group, methylxantines.

   It does this by relaxing the bronchial smooth muscle (relieving bronchospasm) and also stimulate respiration.

     Indicated in: Bronchi asthma, cardiac oedema, chronic asthma e.t.c

  However, it has been discovered to be contra-indicated in certain medical conditions, such as peptic ulcers, hypersensitivity to aminophylline, hyperthyroidism, e.t.c.

      Meanwhile, our main focus here is peptic ulcer (duodenal or gastric). As each year peptic ulcer disease (PUD) affects 4 million people around the world and thirty-five percent of patients diagnosed with gastric ulcers will suffer serious complication. Thorsen, Arne, & Søreide (2013)

    Here is the answer, according to a study carried out few years ago, to compare the effects upon gastric secretion of therapeutic doses of aminophylline, with doxofylline, ( a new xanthine derivative proposed for the treatment of chronic asthma). 

 Twelve patients with endoscopically-proven healed duodenal ulcer were studied twice under double-blind conditions in cross-over experiments. In a 1-hour infusion, six patients received either 240 mg aminophylline i.v. or 200 mg doxofylline i.v., and six received either 240 mg aminophylline i.v. or 400 mg doxofylline i.v. Compared with basal gastric secretion, for the hour after the infusion 240 mg aminophylline i.v. stimulated gastric acid output by a mean 213% (P less than 0.01) and mean pepsin output by 129% (P less than 0.01). Intravenous doxofylline did not stimulate a significant increase of either acid or pepsin output (200 mg: acid output +4%, pepsin output +10%; 400 mg: acid output +25%, pepsin output +27%). These findings suggest that doxofylline, unlike aminophylline, has a low secretagogue activity and it may be more suitable for asthmatic patients with peptic ulcer disease.

REFRENCES:

Thorson K., Arne S., Glomsaker K., &      Søreide K., (2013). Epidemiology     of perforated peptic ulcer: Age-   and gender-adjusted analysis

of incidence and mortality,

 World journal of     Gastroenterology, 19(3): 347–354,

https://www.ncbi.nlm.nih.gov/m/pubmed/2129651/#fft

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