Chronic bronchitis theophylline

Theophylline reduces contractile activity of smooth musculature, widens bronchi and blood vessels, reduces pulmonary vascular resistance, stimulates the respiratory center, and increases the frequency and power of cardiac contractions. It is used for bronchial asthma, preventing attacks, and systematic treatment. Theophylline is also used for symptomatic treatment of bronchospastic syndrome of a different etiology (chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary emphysema). A large number of combined drags are based on theophylline. Synonyms of theophylline are adophyllin, asthmophyllin, theocin, and many others. 

Theophylline (Uniphyllin) treatment and prophylaxis of bronchospasm associated with asthma, chronic obstructive pulmonary disease and chronic bronchitis. Also indicated for the treatment of left ventricular and congestive cardiac failure. 

Theophylline is used as a bronchodilator in the treatment of asthma and reversible bronchospasm associated with chronic bronchitis and emphysema. Unlabeled use includes treatment of sleep apnea in neonates. 

Although chronic theophylline administration has been used extensively in the past, this therapy is being employed with decreasing frequency in favor of aerosolized /32-receptor agonists. Albuterol is used most commonly, one to two puffs of the metered-dose inhaler three to four times daily. The role of aerosolized surfactant also has been assessed in patients with stable chronic bronchitis and has demonstrated encouraging results with respect to improvement in pulmonary function and sputum transport by cilia (i.e., clearance). The role of surfactant as a carrier vehicle for other aerosol medications also appears promising and most likely will continue to be evaluated. 

Theophylline - bronchodilator asthma, chronic bronchitis Thipental - intravenous general anaesthetic Tiabendazole - anthelmintic Tioconazole - antifungal... 

Dyphylline is a xanthine derivative related to theophylline. It relaxes bronchial smooth muscle and stimulates central respiratory drive. It is indicated in the relief of acute bronchial asthma and reversible bronchospasm associated with chronic bronchitis and emphysema. A large number of derivatives of the methylxanthines have been prepared and examined for their ability to inhibit cyclic nucleotide phosphodiesterases (PDFs) and antagonize receptor-mediated actions of adenosine, the two best characterized cellular actions of the methylxanthines. Although certain modifications dissociate these two activities to some degree, these compounds are not used therapeutically. 

Theophylline, a bronchodilator, is indicated for the symptomatic relief of bronchospasm in patients not currently receiving theophylline who require rapid relief of acute symptoms and for prophylaxis of bronchial asthma, bronchospasm of chronic bronchitis, and emphysema (see also Figure 94). 

Reisz G, Pingleton SK, Meletiiil S, Ryan PB. The effect of erythromycin on theophylline pharmacokinetics in chronic bronchitis. Am RevRespirDis (1983) 127,581-4. 

In a pooled analysis of two identical multicenter randomized placebo-controlled trials, roflumilast ( = 1537) and placebo ( = 1534) were compared in patients with severe COPD with a chronic bronchitis phenotype and at least one exacerbation requiring glucocorticoids treatment in the previous year [113 ]. Inhaled glucocorticoids, tiotropium, and theophylline were not allowed. Treatment with roflumilast increased the pre-bronchodilator FEVj and reduced the rate of exacerbations. However, adverse events were more common in the intervention group (67% versus 62%), and withdrawal secondary to these effects including headaches, nausea, and diarrhea,... 

Although it has been largely replaced by inhaled agonists, theophylline continues to be used for the treatment of bronchospasm by some patients with asthma and bronchitis (see Chapter 20). A dose of 20-30 tablets can cause serious or fatal poisoning. Chronic or subacute theophylline poisoning can also occur as a result of accidental overmedication or use of a drug that interferes with theophylline metabolism (eg, cimetidine, ciprofloxacin, erythromycin see Chapter 4). 

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