Nocturnal asthma and timing of treatment

Li, James T.C.; Reed, Charles E.

doi:10.1016/0002-9343(85)90081-6

Cited by 8 publications

(2 citation statements)

References 29 publications

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“…In a questionnaire survey of 7729 asthmatic patients being treated by primary care physicians in many parts of the UK, Turner-Warwick (1988) found that 39% reported nightly nocturnal wakenings, with 74% waking at least one night per week. When compared with morning administration, controlled release theophylline preparations are more slowly absorbed at night and achieve lower peak concentrations, which occur in the early hours of the morning (Li & Reed 1985). When compared with morning administration, controlled release theophylline preparations are more slowly absorbed at night and achieve lower peak concentrations, which occur in the early hours of the morning (Li & Reed 1985).…”

Section: Clinical Benefitsmentioning

confidence: 99%

“…The recommended therapeutic range is 55 to III ILmol/L, and the incidence of serious adverse effects increases as the concentration rises above the upper limit of this range. Absorption is slower at night, with morning pre-dose trough concentrations higher than those at night (Li & Reed 1985). The use of mixed stimulated saliva theophylline concentrations may be used as a noninvasive method of monitoring unbound serum theophylline concentrations, with a therapeutic range of 31 to 63 ILmol/L (Blanchard et al 1991).…”

Section: Risks Of Theophylline Usementioning

confidence: 99%

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Theophylline

Nasser

Rees²

1993

Drug Safety

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Theophylline and its derivatives have been used in the treatment of asthma for over 50 years, but since the advent of more potent bronchodilators their use has become cloaked in controversy. Their continued existence results from their undoubted usefulness in severe acute asthma, nocturnal asthma, childhood asthma and moderate to severe chronic airflow limitation, and because of habitual use by physicians in other situations. The precise mechanism of action of theophylline remains uncertain. The role of phosphodiesterase inhibition and adenosine antagonism has been reviewed and the clinical significance of the anti-inflammatory action of theophylline discussed. Theophylline has unpredictable metabolism when first administered, and continued monitoring of drug concentrations is essential. Commonly encountered adverse effects may occur at therapeutic serum concentrations, frequently necessitating drug withdrawal. The overlapping therapeutic and toxic theophylline serum ranges can lead to life-threatening adverse effects at the upper end of the therapeutic range, especially in the elderly in whom special precaution is required.

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Section: Clinical Benefitsmentioning

confidence: 99%

Section: Risks Of Theophylline Usementioning

confidence: 99%