ABSTRACT
For decades theophylline was used as a bronchodilator for the relief of
acute asthmatic symptoms, initially in patients unresponsive to injected epinephrine (1), and subsequently as an oral agent in fixed dose combination
with a weak sympathomimetic bronchodilator, ephedrine (2). It had also
been used as a respiratory stimulant for Cheyne-Stokes respirations (3),
as a diuretic in the treatment of acute pulmonary edema (4,5), to prevent
episodes of apnea and bradycardia in premature newborns (6,7), as an aid
in weaning very low birth weight infants from mechanical ventilation (8),
and extensively in the treatment of chronic obstructive pulmonary disease
(COPD) (9,10). It’s most important use eventually became as maintenance therapy for controlling the symptoms of chronic asthma (11). Studies of
the pharmacodynamic and pharmacokinetic characteristics of theophylline,
the development of reliably absorbed slow-release formulations, and the
availability of rapid, specific serum assays improved both the efficacy and
safety of this drug (12). Identification of anti-inflammatory effects for
theophylline has increased current interest in this venerable medication (13).
