Theophylline use: an overview.

Area of Science:

• Pharmacology
• Pulmonary Medicine
• Clinical Therapeutics

Background:

• Theophylline, a methylated xanthine, is a well-established maintenance therapy for chronic asthma.
• Advances in understanding its pharmacodynamics and pharmacokinetics have solidified its role as an effective nonsteroidal prophylactic agent.
• Despite the availability of numerous asthma medications, theophylline remains a valuable option due to its high efficacy when used correctly.

Purpose of the Study:

• To address critical issues concerning theophylline: its nature, rationale for use, administration guidelines, and patient selection.
• To highlight the importance of appropriate use for achieving maximal safe therapeutic effects.
• To delineate the appropriate role of theophylline in managing asthma and other obstructive pulmonary diseases.

Main Methods:

• Review of theophylline's established clinical benefits, pharmacodynamics, and pharmacokinetics.
• Discussion of therapeutic serum concentration ranges (10-20 micrograms/ml).
• Emphasis on individualized dosage titration guided by serum concentration monitoring and clinical tolerance.

Main Results:

• Theophylline offers significant efficacy for chronic asthma maintenance therapy.
• Maintaining serum concentrations between 10-20 micrograms/ml is crucial for optimal and safe effects.
• Individualized dosing and appropriate product selection are key to stable serum concentrations.

Conclusions:

• Theophylline's efficacy justifies its continued use in asthma management when administered appropriately.
• Intermittent asthma symptoms are better managed with inhaled bronchodilators and short-term corticosteroids.
• Theophylline use in non-asthma obstructive pulmonary diseases should be selective and based on proven clinical benefit.