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post in: Health, News Date:11 Oct 2017, 15:27 views:3507
Methylxanthines, the role allergy of methylxanthines, such as theophylline or aminophylline, in the treatment of severe acute asthma allergy has been diminished since the advent of potent selective beta-agonists and their use at higher doses.
26, at therapeutic doses, methylxanthines are weaker bronchodilators than beta-agonists and have many undesirable adverse effects, such as frequent induction of nausea and vomiting.
Furthermore, most studies have failed to show additional benefit when methylxanthines are administered to patients who are already receiving frequent beta-agonists and corticosteroids. Nevertheless, several prospective, randomized, controlled studies in children with refractory status asthmaticus have reexamined the role of the methylxanthines theophylline and aminophylline and have demonstrated improvement in the clinical asthma scores when compared with placebo control.
One study compared intravenous theophylline with intravenous terbutaline in critically ill children with refractory asthma and demonstrated equal therapeutic efficacy but significantly lower costs associated with theophylline use. 27, theophylline, among the effects of theophylline that are important in managing asthma are bronchodilatation, increased diaphragmatic function, and central stimulation of breathing.
Usually, theophylline is given parenterally, but it can also be given orally, depending on the severity of the asthma attack and the patient's ability to take medications.
This class of drugs can induce tachycardia and decrease the seizure threshold (especially in children therefore, therapeutic monitoring is mandatory.
In the past the typical theophylline therapeutic levels ranged from 10-20 mcg/mL.
However, adverse effects can occur even with therapeutic levels.
A lower therapeutic range of 8-15 mcg/mL has therefore been adopted by many institutions.
Seizures have occurred even with levels below 10 mcg/mL.