Abstract
The narrow therapeutic index, potential toxicity, and need to monitor plasma concentrations make theophyllines difficult to use. Other drugs provide comparable or better bronchodilator and prophylactic efficacy. In asthma theophyllines should be considered for chronic stable asthma when treatment with optimal doses of inhaled steroids and bronchodilators fails to provide adequate control; for nocturnal asthma; and for prophylaxis and relief of symptoms in children and adults when inhaled treatment cannot be given. In general, theophyllines cannot be recommended for chronic airflow obstruction. A trial of theophylline is reasonable in individual patients whose symptoms remain troublesome despite a trial of steroids and optimal doses of inhaled bronchodilators.
Full text
PDF


Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barnes P. J., Greening A. P., Neville L., Timmers J., Poole G. W. Single-dose slow-release aminophylline at night prevents nocturnal asthma. Lancet. 1982 Feb 6;1(8267):299–301. doi: 10.1016/s0140-6736(82)91566-5. [DOI] [PubMed] [Google Scholar]
- Bukowskyj M., Nakatsu K., Munt P. W. Theophylline reassessed. Ann Intern Med. 1984 Jul;101(1):63–73. doi: 10.7326/0003-4819-101-1-63. [DOI] [PubMed] [Google Scholar]
- Chrystyn H., Mulley B. A., Peake M. D. Dose response relation to oral theophylline in severe chronic obstructive airways disease. BMJ. 1988 Dec 10;297(6662):1506–1510. doi: 10.1136/bmj.297.6662.1506. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cochrane G. M. Slow release theophyllines and chronic bronchitis. Br Med J (Clin Res Ed) 1984 Dec 15;289(6459):1643–1644. doi: 10.1136/bmj.289.6459.1643. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Doskocil M., Med M., Vimmer T. Musculus rectus femoris--zacátecní slacha, její funkcní význam. Acta Chir Orthop Traumatol Cech. 1987 Apr;54(2):99–107. [PubMed] [Google Scholar]
- Dullinger D., Kronenberg R., Niewoehner D. E. Efficacy of inhaled metaproterenol and orally-administered theophylline in patients with chronic airflow obstruction. Chest. 1986 Feb;89(2):171–173. doi: 10.1378/chest.89.2.171. [DOI] [PubMed] [Google Scholar]
- Edmunds A. T., Carswell F., Robinson P., Hughes A. O. Controlled trial of cromoglycate and slow-release aminophylline in perennial childhood asthma. Br Med J. 1980 Sep 27;281(6244):842–842. doi: 10.1136/bmj.281.6244.842. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Edmunds A. T., McKenzie S., Baillie E., Tooley M., Godfrey S. A comparison of oral choline theophyllinate and beclomethasone in severe perennial asthma in children. Br J Dis Chest. 1979 Apr;73(2):149–156. [PubMed] [Google Scholar]
- Ellis E. F. Inhibition of exercise-induced asthma by theophylline. J Allergy Clin Immunol. 1984 May;73(5 Pt 2):690–692. doi: 10.1016/0091-6749(84)90307-5. [DOI] [PubMed] [Google Scholar]
- Fanta C. H., Rossing T. H., McFadden E. R., Jr Treatment of acute asthma. Is combination therapy with sympathomimetics and methylxanthines indicated? Am J Med. 1986 Jan;80(1):5–10. doi: 10.1016/0002-9343(86)90041-0. [DOI] [PubMed] [Google Scholar]
- Greening A. P., Baillie E., Gribbin H. R., Pride N. B. Sustained release oral aminophylline in patients with airflow obstruction. Thorax. 1981 Apr;36(4):303–307. doi: 10.1136/thx.36.4.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Guyatt G. H., Townsend M., Pugsley S. O., Keller J. L., Short H. D., Taylor D. W., Newhouse M. T. Bronchodilators in chronic air-flow limitation. Effects on airway function, exercise capacity, and quality of life. Am Rev Respir Dis. 1987 May;135(5):1069–1074. doi: 10.1164/arrd.1987.135.5.1069. [DOI] [PubMed] [Google Scholar]
- Handslip P. D., Dart A. M., Davies B. H. Intravenous salbutamol and aminophylline in asthma: a search for synergy. Thorax. 1981 Oct;36(10):741–744. doi: 10.1136/thx.36.10.741. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hill N. S. The use of theophylline in 'irreversible' chronic obstructive pulmonary disease. An update. Arch Intern Med. 1988 Dec;148(12):2579–2584. [PubMed] [Google Scholar]
- Klein J. J., Lefkowitz M. S., Spector S. L., Cherniack R. M. Relationship between serum theophylline levels and pulmonary function before and after inhaled beta-agonist in "stable" asthmatics. Am Rev Respir Dis. 1983 Apr;127(4):413–416. doi: 10.1164/arrd.1983.127.4.413. [DOI] [PubMed] [Google Scholar]
- Siegel D., Sheppard D., Gelb A., Weinberg P. F. Aminophylline increases the toxicity but not the efficacy of an inhaled beta-adrenergic agonist in the treatment of acute exacerbations of asthma. Am Rev Respir Dis. 1985 Aug;132(2):283–286. doi: 10.1164/arrd.1985.132.2.283. [DOI] [PubMed] [Google Scholar]
- Smith J. A., Weber R. W., Nelson H. S. Theophylline and aerosolized terbutaline in the treatment of bronchial asthma. Double-blind comparison of optimal doses. Chest. 1980 Dec;78(6):816–818. doi: 10.1378/chest.78.6.816. [DOI] [PubMed] [Google Scholar]
- Taylor D. R., Buick B., Kinney C., Lowry R. C., McDevitt D. G. The efficacy of orally administered theophylline, inhaled salbutamol, and a combination of the two as chronic therapy in the management of chronic bronchitis with reversible air-flow obstruction. Am Rev Respir Dis. 1985 May;131(5):747–751. doi: 10.1164/arrd.1985.131.5.747. [DOI] [PubMed] [Google Scholar]
- Woodcock A. A., Johnson M. A., Geddes D. M. Theophylline prescribing, serum concentrations, and toxicity. Lancet. 1983 Sep 10;2(8350):610–613. doi: 10.1016/s0140-6736(83)90691-8. [DOI] [PubMed] [Google Scholar]
- Zwillich C. W., Neagley S. R., Cicutto L., White D. P., Martin R. J. Nocturnal asthma therapy. Inhaled bitolterol versus sustained-release theophylline. Am Rev Respir Dis. 1989 Feb;139(2):470–474. doi: 10.1164/ajrccm/139.2.470. [DOI] [PubMed] [Google Scholar]