Therapy of asthma with theophylline preparations

: Theophylline, 1.3-dimethylpurindione-(2.6), is a common component as well of the basic treatment of obstructive lung disease as of the emergency therapy of asthma. Until now, the mode of action of the bronchodilating effect is not elucidated. Probably, the antagonistic action upon adenosine plays a central role. The clearance of theophylline is decisive for the serum level. It varies inter- and intraindividually, depending upon different factors, e. g. simultaneous application of other drugs, coexisting diseases, and circadian rhythms. Slow-release preparations are a progress in the basic treatment of bronchial asthma and chronic obstructive bronchitis. Among other items, they are especially advantageous in the treatment of bronchial obstructions during night-time. Theophylline-ethylendiamine (aminophylline) can be given intravenously and thus is the drug of choice in severe attacks of asthma. For optimal therapeutic effects, serum levels between 8 and 20 micrograms/ml are necessary. Side effects are observed mainly with serum levels above 15 micrograms/ml, concerning gastrointestinal tract, central nervous system, and cardiovascular system. Mild side effects are frequent. The most serious adverse reaction are epileptiform reactions. In perspective, by differentiation of adenosine-receptor-subtypes, the development of new xanthine-derivatives with most favourable action could be feasible.