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A Reappraisal

William L. Dull, MD; Michael R. Alexander, MS

Arch Intern Med. 1984;144(12):2399-2401.

Abstract
• Theophylline is commonly recommended for patients who have stable chronic airflow obstruction (CAO). Recent evidence confirms that serum theophylline concentrations between 10 and 20 mg/L may increase forced expiratory volume in 1 s (FEV₁) and forced vital capacity in these patients. Exercise tolerance, however, and the classic respiratory symptoms of wheezing, breathlessness, cough, and sense of well-being do not improve. A reappraisal of the role of this medication in patients with stable CAO is therefore necessary; we recommend not prescribing this medication for all patients. Instead, the response of FEV₁ after isoproterenol inhalation (0.15 mg) should be monitored. This simple test has good efficacy for predicting the response to oral theophylline therapy and could diminish the cost and unnecessary side effects of theophylline while benefiting those who will respond.

(Arch Intern Med 1984;144:2399-2401)

Author Affiliations
From the Department of Pharmacy, Veterans Administration Hospital, Iowa City.

Footnotes
Accepted for publication March 12,1984.

Reprint requests to 19 Evans St, Iowa City, IA 52240 (Dr Dull).

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