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Theophylline for Chronic Asthma: Rationale for Treatment, Product Selection, and Dosage Schedule

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Abstract:

Theophylline has emerged as one of the most useful non-corticosteroid agents available for suppressing symptoms in the patient with chronic asthma. Maximal benefit, however, requires appreciation of the pharmacodynamics and pharmacokinetics of this drug. At concentrations between 10 and 20 mcg/ml, optimal likelihood of benefit without toxicity is attained and symptoms of asthma are virtually eliminated in many patients and are significantly decreased even in patients requiring inhaled or oral corticosteroids. Interpatient variability in the rate of drug elimination, however, results in a wide range of doses to attain these serum concentrations. Initiation of therapy with low doses and the determination of final dosage by measurement of serum theophylline concentration is essential for safe and effective use. A simple and efficient dosing schedule has been developed that virtually eliminates problems of intolerance of the drug and results in all but about 1% of children and almost as many adults tolerating theophylline without adverse effects. Sustained-release theophylline preparations, when reliably and completely absorbed, offer major therapeutic advantage by minimizing fluctuations in serum concentration and consequent variation in effect between doses. While products vary in rate and completeness of absorption, stabilization of the airway hyperreactivity of asthma can be attained with 12 hour dosing for most patients with some, but not all, of the new formulations.

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/108854183779050059

Affiliations: Pediatric Allergy and Pulmonary Division, The University of Iowa Hospitals and Clinics, Iowa City, Iowa 5242

Publication date: September 1, 1983

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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