Ipswich and East Suffolk CCG
North East Essex CCG
East Suffolk and North East Essex NHS Foundation Trust

3 Respiratory system

MHRA:Pressurised metered dose inhalers (pMDI): risk of airway obstruction from aspiration of loose objects


The following acronyms may be mentioned in this section in reference to inhalers

  • MDI- Metered dose inhaler
  • DPI- Dry powder inhaler
  • BAA- Breath actuated aerosol
  • ICS- Inhaled corticosteroid
  • SABA- Short-acting bronchodilator
  • LABA- Long-acting bronchodilator
  • SAMA- Short-acting muscarinic
  • LAMA - Long-acting muscarinic

Local guidance


IESCCG Asthma Action Plan

NEECCG Asthma plan (Asthma UK)

Joint Asthma quick reference guide - adults

Asthma quick reference guide – children (5yrs-12yrs)

Asthma quick reference guide – children (over 12yrs)

Asthma quick reference guide – children (under 5yrs)

Asthma step down guidance - adults


Joint COPD Quick Reference Guide

IESCCG COPD action plan

NEECCG COPD patient passport

Other documents

Inhaler switching

03-01-03 Theophylline

Therapuetic Drug Monitoring Information

Please note oral theophylline/aminophylline must be specified by brand

Different brands are not interchangeable

Check interactions with theophyline before prescribing new drugs as further monitoring may be required

Factors to consider in TDM Information Further details
When level should be done (after initiation) 5 days  
When bloods should be taken 4-6hrs post dose  
Optimal drug levels 10–20 mg/litre
(55–110 micromol/litre)
Lower drug levels may still provide therapuetic benefit
When levels should be taken again following dose alteration 3 days  
Non-drugs factors which can affect levels Increased in:
  • Heart failure
  • Hepatic impairment
  • Viral infections
  • Elderly patients
Decreased in:
  • Smokers
  • Alcohol consumption
Consider levels if there are changes in the non-drug factors listed
Signs of toxicity
  • Nausea
  • Vomiting - Severe and protracted
  • Abdominal pain
  • Mild metabolic acidosis
  • Hypokalemia
  • Tachycardia
  • Hypophosphatemia
  • Hypomagnesemia
  • Hypocalcemia/hypercalcemia
  • Hyperglycemia
Seek advice if suspected

Uniphyllin® Continus
First Choice

Always prescribe by brand

Blue View adult BNF  View SPC online  View childrens BNF
Phyllocontin Continus® Aminophylline

Always prescribe by brand

February 2021:  

Phyllocontin® (aminophylline) Continus 225mg and Phyllocontin® Forte Continus 350mg modified-release tablets are being discontinued in the UK.  
Remaining supplies of the 225mg strength are expected to be exhausted by 2nd March 2021 and the 350mg strength are expected to be exhausted by 5th April 2021.
Please click here for further information

Blue View adult BNF  View SPC online  View childrens BNF
Aminophylline IV

Red Hospital View adult BNF  View SPC online  View childrens BNF