Intravenous theophylline therapy in asthma: a clinical update

Theophylline preparations have long been the mainstay in the management of asthma. Recently clinical and laboratory investigations have provided us with some useful information regarding the appropriate dosage and elimination of the drug. If morbidity is to be avoided, knowledge of the basic pharmacokinetics of theophylline, as well as recognition of the parameters which have clinically significant influences on those kinetics, is essential to the emergency physician who has occasion to treat asthmatics. Theophylline levels should be utilized whenever available, but clinical acumen must suffice in their absence. Subtle signs of toxicity must be recognized before more serious complications ensue. Armed with more recent knowledge, the emergency physician should be able to provide optimal therapy for the asthmatic.