Aminophylline Induced Blood Pressure Decrease in Patients with Acute Phase Non-Hemorrhagic Stroke and Chronic Obstrutive Pulmonary Disease (COPD)

Authors

  • Sayyid Muhammad Sahil Haikal General Hospital Abdul Rivai Berau
  • Aryo Dirgantara Putra Laboratory of Pulmonology Faculty of Medicine Universitas Mulawarman Samarinda

DOI:

https://doi.org/10.21776/ub.jkb.2025.033.03.13

Keywords:

Aminophylline, acute phase NHS, COPD, hypotension

Abstract

Stroke and Chronic Obstrutive Pulmonary Disease (COPD) are two diseases that have high mortality and disability rates in the world. Smoking is one of the risk factors that cause these two diseases. The occurrence of Non-Hemorrhagic Stroke (NHS) and COPD simultaneously in one patient will cause a poor prognosis and more comprehensive treatment. In addition, there are no therapeutic guidelines for these two diseases if they occur together. This case report reports a case of NHS and COPD in a 64-year-old man who received aminophylline therapy. The patient experienced hypotension on the second day of treatment induced by aminophylline administration. Discontinuation of aminophylline therapy in the patient and administration of other supportive therapies for NHS and COPD showed improvements in blood pressure and other medical conditions related to the patient's disease on the sixth day of treatment. A decrease in blood pressure by >15% in the acute phase of NHS is a quite dangerous condition because it causes a lack of collateral blood flow which results in a lack of blood flow in the penumbra area. Administration of aminophylline has the effect of lowering blood pressure because it increases the release of catecholamines that stimulate beta adrenergic to reduce vascular resistance. Aminophylline should be given >48 hours after the attack to prevent the expansion of cerebral infarction and recurrent NHS attacks and strict monitoring is required when administering COPD therapy accompanied by NHS in relation to the effects caused by the administration of this therapy.

Downloads

Download data is not yet available.

References

1. Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet. International Journal of Stroke. 2022; 17(1): 18-29.

2. Mulyani L, Marjan AQ, Arini FA, and Octaria YC. Risk Factor Analysis for Stroke Incidence in North Sulawesi: Based on the 2018 Indonesia Basic Health Research. Jurnal Ilmu Kesehatan Masyarakat. 2024; 15(1): 70-84.

3. Tobing NHML, Jasngari L, and Sahetapi CM. The Analysis of Hemorrhagic and Non-Hemorrhagic Stroke Risk. International Journal of Health Science and Research. 2022; 12: 173-186

4. Boehme AK, Esenwa C, and Elkind MSV. Stroke Risk Factors, Genetics, and Prevention. Circulation Research. 2017; 120(3): 472-495.

5. Pan B, Jin X, Jun L, Qiu S, Zheng Q, and Pan M. The Relationship between Smoking and Stroke: A Meta-Analysis. Medicine. 2019; 98(12): 1-8.

6. Markidan J, Cole JW, Cronin CA, et al. Smoking and Risk of Ischemic Stroke in Young Men. Stroke. 2018; 49(5): 1276–1278.

7. Whittaker H, Rothnie KJ, Quint JK. Cause-Spesific Mortality in COPD Subpopulations: A Cohort Study of 339 647 People in England. Thorax. 2024; 79(3): 202-208.

8. Ding C, Wang R, Gong X, and Yuan Y. Stroke Risk of COPD Patients and Death Risk of COPD Patients Following a Stroke. Medicine. 2023; 102(47): 1-11.

9. Salman IPP, Haiga Y, and Wahyuni, S. Perbedaan Diagnosis Stroke Iskemik dan Stroke Hemoragik dengan Hasil Transcranial Doppler di RSUP Dr. M. Djamil Padang. Scientific Journal. 2022; 1(5): 393-402

10. Salaudeen MA, Bello N, Danraka RN, and Ammani ML. Understanding the Pathophsiology of Ischemic Stroke: The Basis of Current Therapies and Opportunity for New Ones. Biomolecules. 2024; 14(3): 1-23.

11. Ząbczyk M, Ariëns RAS, and Undas A. Fibrin Clot Properties in Cardiovascular Disease: From Basic Mechanisms to Clinical Practice. Cardiovascular Research. 2023; 119(1): 94-111.

12. Adam MF, Hutahaean YO, and Siagian LRD. Gambaran Profil Lipid dan Rasio Lipid pada Pasien Stroke Iskemik Berulang di RSUD Abdul Wahab Sjahranie Samarinda. Jurnal Kedokteran Mulawarman. 2020; 7(2): 1-10.

13. Bourdin A, Burgel PR, Chanez P, Garcia G, Perez T, and Roche N. Recent Advances in COPD: Pathophysiology, Respiratory Physiology and Clinical Aspects, Including Comorbidities. European Respiratory Review. 2009; 18(114): 198-212.

14. Austin V, Crack PJ, Bozinovski S, Miller AA, and Vlahos R. COPD and Stroke: Are Systemic Inflammation and Oxidative Stress the Missing Links? Clinical Science. 2016; 130(13): 1039-1050.

15. Jha P. The Hazards of Smoking and the Benefits of Cessation: A Critical Summation of the Epidemiological Evidence in High-Income Countries. eLife. 2020; 9: 1-47.

16. Sharmin N, Rahman Z, Yususf A, and Rahman N. Risk of Smoking in the Causation of Ischemic Stroke: Experience of 100 Cases in Bangladesh. European Journal of Preventive Medicine. 2016; 4(6): 132-135.

17. Sakinah S and Nugroho SD. Relationship between Smoking and Ischemic Stroke: Meta-Analysis. Journal of Epidemiology and Public Health. 2022; 7(1): 110-119.

18. Mazzone P, Tierney W, Hossain M, Puvenna V, Janigro D, Cucullo L. Pathophysiological Impact of Cigarette Smoke Exposure on the Cerebrovascular System with a Focus on the Blood-Brain Barrier: Expanding the Awareness of Smoking Toxicity in an Underappreciated Area. International Journal of Environmental Research and Public Health. 2010; 7(12): 4111–4126.

19. Szylińska A, Kotfis K, Bott-Olejnik M, Wańkowicz P, and Rotter I. Post-Stroke Outcomes of Patients with Chronic Obstructive Pulmonary Disease. Brain Sciences. 2022; 12(1): 1-11.

20. Kim SM, Woo HG, Kim YJ, and Kim BJ. Blood Pressure Management in Stroke Patients. Journal of Neurocritical Care. 2020; 13(2): 69-79.

21. Greene SC, Halmer T, Carey JM, Rismiller BJ, and Musick MA. Teophylline Toxicity: An Old Poisoning for a New Generation of Physicians. Turkish Journal of Emergency Medicine. 2018; 18(1): 37-39.

22. Scurek M and Brat K. A Narrative Review of Theophylline: Is There Still a Place for an Old Friend? Journal of Thoracic Disease. 2024; 16(5): 3450-3460.

23. Corlateanu A, Covantev S, Mathioudakis A, Botnaru V, Cazzola M, and Siafakas N. Chronic Obstructive Pulmonary Disease and Stroke. Journal of Chronic Obstructive Pulmonary Disease. 2018; 15(4): 405-413.

24. Verhamme KMC, Afonso ASM, van Noord CV, et al. Tiotropium Handihaler and the Risk of Cardio or Cerebrovascular Events and Mortality in Patients with COPD. Pulmonary Pharmacology & Therapeutics. 2012; 25(1): 19-26.

25. Echevarria C, Steer J, Wason J, and Bourke S. Oxygen Therapy and Inpatient Mortality in COPD Exacerbation. Emergency of Medicine Journal. 2021; 38(3): 170-177.

Downloads

Published

2025-02-28

Issue

Section

Case Report

Similar Articles

1-10 of 36

You may also start an advanced similarity search for this article.