Theophylline has been a popular medication for asthma for over50 years. However, the introduction of newer pharmacologic agents,concern about the toxicity of theophylline, and recommendationsin widely disseminated guidelines have recently contributedto its decreased use. In this review we reassess the role oftheophylline in the pharmacotherapy of asthma and specificallyaddress three pivotal questions: What are the data justifyingits continued use? What are its risks? What is its role in thetreatment of patients with asthma?
History
Although first used as intravenous therapy for acute asthma1and then as an oral medication in fixed doses in . . . [Full Text of this Article]
Pharmacologic Actions
Molecular Mechanisms of Action
Comparison with Alternative Drugs
Intervention for Relief of Acute Symptoms
Maintenance Therapy for Chronic Asthma
Pharmacodynamics
Pharmacokinetics
Dosage
Precautions
Safety
Indications
The Future Role of Theophylline
Source Information
From the Department of Pediatrics, University of Iowa College of Medicine, Iowa City (M.W.), and the College of Pharmacy and Department of Pediatrics, College of Medicine, University of Florida, Gainesville (L.H.).
Address reprint requests to Dr. Weinberger at the Department of Pediatrics, University of Iowa Hospital, 200 Hawkins Dr., Iowa City, IA 52242-1083.
References
This article has been cited by other articles:
The American Lung Association Asthma Clinical Rese,
(2007). Clinical Trial of Low-Dose Theophylline and Montelukast in Patients with Poorly Controlled Asthma. Am. J. Respir. Crit. Care Med.
175: 235-242
[Abstract][Full Text]
Rutten, J., van den Berg, B., van Gelder, T., van Saase, J.
(2005). Severe theophylline intoxication: a delay in charcoal haemoperfusion solved by oral activated charcoal. Nephrol Dial Transplant
20: 2868-2869
[Full Text]
Chu, E. K., Drazen, J. M.
(2005). Asthma: One Hundred Years of Treatment and Onward. Am. J. Respir. Crit. Care Med.
171: 1202-1208
[Abstract][Full Text]
RuDusky, B. M.
(2005). Aminophylline: Exploring Cardiovascular Benefits Versus Medical Malcontent. ANGIOLOGY
56: 295-304
[Abstract]
Benoehr, P., Krueth, P., Bokemeyer, C., Grenz, A., Osswald, H., Hartmann, J. T.
(2005). Nephroprotection by Theophylline in Patients with Cisplatin Chemotherapy: A Randomized, Single-Blinded, Placebo-Controlled Trial. J. Am. Soc. Nephrol.
16: 452-458
[Abstract][Full Text]
Inbe, H., Watanabe, S., Miyawaki, M., Tanabe, E., Encinas, J. A.
(2004). Identification and Characterization of a Cell-Surface Receptor, P2Y15, for AMP and Adenosine. J. Biol. Chem.
279: 19790-19799
[Abstract][Full Text]
Barr, R G., Rowe, B. H, Camargo, C. A Jr
(2003). Methylxanthines for exacerbations of chronic obstructive pulmonary disease: meta-analysis of randomised trials. BMJ
327: 643-
[Abstract][Full Text]
Foukas, L. C., Daniele, N., Ktori, C., Anderson, K. E., Jensen, J., Shepherd, P. R.
(2002). Direct Effects of Caffeine and Theophylline on p110delta and Other Phosphoinositide 3-Kinases. DIFFERENTIAL EFFECTS ON LIPID KINASE AND PROTEIN KINASE ACTIVITIES. J. Biol. Chem.
277: 37124-37130
[Abstract][Full Text]
Bourdet, S. V., Williams, D.
(2001). Management Considerations for Chronic Asthma. Journal of Pharmacy Practice
14: 108-125
[Abstract]
Beauchesne, M.-F.
(2001). Management of Chronic Obstructive Pulmonary Disease: A Review. Journal of Pharmacy Practice
14: 126-142
[Abstract]
Hart, S.P.
(2000). Should aminophylline be abandoned in the treatment of acute asthma in adults?. QJM
93: 761-765
[Abstract][Full Text]
Miura, T., Kimura, K.
(2000). Theophylline-Induced Convulsions in Children With Epilepsy. Pediatrics
105: 920-920
[Full Text]
Shannon, M.
(1999). Life-Threatening Events After Theophylline Overdose: A 10-Year Prospective Analysis. Arch Intern Med
159: 989-994
[Abstract][Full Text]
McConnell, S. A., Nafziger, A. N., Amsden, G. W.
(1999). Lack of effect of dirithromycin on theophylline pharmacokinetics in healthy volunteers. J Antimicrob Chemother
43: 733-736
[Abstract][Full Text]
CHEUNG, D., WEVER, A. M. J., de GOEIJ, J. A., de GRAAFF, C. S., STEEN, H., STERK, P. J.
(1998). Effects of Theophylline on Tolerance to the Bronchoprotective Actions of Salmeterol in Asthmatics In Vivo. Am. J. Respir. Crit. Care Med.
158: 792-796
[Abstract][Full Text]
Trépanier, E. F., Nafziger, A. N., Amsden, G. W.
(1998). Effect of Terbinafine on Theophylline Pharmacokinetics in Healthy Volunteers. Antimicrob. Agents Chemother.
42: 695-697
[Abstract][Full Text]
Feoktistov, I., Biaggioni, I.
(1997). Adenosine A2B Receptors. Pharmacol. Rev.
49: 381-402
[Abstract][Full Text]
Evans, D. J., Taylor, D. A., Zetterstrom, O., Chung, K. F., O'Connor, B. J., Barnes, P. J.
(1997). A Comparison of Low-Dose Inhaled Budesonide plus Theophylline and High-Dose Inhaled Budesonide for Moderate Asthma. NEJM
337: 1412-1419
[Abstract][Full Text]
Carlstedt, B. C.
(1997). Pharmacotherapy of Asthma. Journal of Pharmacy Practice
10: 147-164
[Abstract]