{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:32:34Z","timestamp":1790188354246,"version":"4.1.0"},"reference-count":39,"publisher":"BMJ","issue":"6729","license":[{"start":{"date-parts":[[1990,4,7]],"date-time":"1990-04-07T00:00:00Z","timestamp":639446400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1990,4,7]]},"abstract":"<jats:p>The narrow therapeutic index, potential toxicity, and need to monitor plasma concentrations make theophyllines difficult to use. Other drugs provide comparable or better bronchodilator and prophylactic efficacy. In asthma theophyllines should be considered for chronic stable asthma when treatment with optimal doses of inhaled steroids and bronchodilators fails to provide adequate control; for nocturnal asthma; and for prophylaxis and relief of symptoms in children and adults when inhaled treatment cannot be given. In general, theophyllines cannot be recommended for chronic airflow obstruction. A trial of theophylline is reasonable in individual patients whose symptoms remain troublesome despite a trial of steroids and optimal doses of inhaled bronchodilators.<\/jats:p>","DOI":"10.1136\/bmj.300.6729.929","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"929-931","source":"Crossref","is-referenced-by-count":20,"title":["Theophylline in the management of airflow obstruction. 2. Difficult drugs to use, few clinical indications."],"prefix":"10.1136","volume":"300","author":[{"given":"I D","family":"Johnston","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1990,4,7]]},"reference":[{"key":"ref_1","first-page":"824","article-title":"Clinical trials in acute severe asthma: are type II errors important?","volume":"41","author":"Ward, M.J.","year":"1986","unstructured":"Ward MJ. Clinical trials in acute severe asthma: are type II errors important? T'horax 1986;41:824-9.","journal-title":"T'horax"},{"key":"ref_2","first-page":"385","article-title":"Aminophylline salbtitamol and combined intravenous infusions in acute sevcre asthma","volume":"74","author":"Evans, M.V.; MN5oiijc, R.D.H.; Crimmins, J.; Seaton, A.","year":"1980","unstructured":"Evans MV, MN5oiijc RDH, Crimmins J, Seaton A. Aminophylline salbtitamol and combined intravenous infusions in acute sevcre asthma. 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Single-dose slowrelease aminophvlline at night prevents nocturnal asthma. I.ancet 1982;i: 299-301.","journal-title":"I.ancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1164\/ajrccm\/139.2.470","article-title":"Nocturnal asthma therapy","volume":"139","author":"Zwillich, C.W.; Neagley, SR, Cicutto; L, White; DP, Martin; R.W.","year":"1989","unstructured":"Zwillich CW, Neagley SR, Cicutto L, White DP, Martin RW. Nocturnal asthma therapy. Am Rez, Respir Dis 1989;139:470-4.","journal-title":"Am Rez, Respir Dis"},{"key":"ref_8","first-page":"787","article-title":"Eft'ect of' oral salbutamol and slow-release aminophylline on exercise tolerance in chronic broiichitis","volume":"36","author":"Leitch, A.G.; Morgan, A.; Ellis, D.A.; Bell, G.; Haslett, C.; McHardy, G.J.R.","year":"1981","unstructured":"Leitch AG, Morgan A, Ellis DA, Bell G, Haslett C, McHardy GJR. Eft'ect of' oral salbutamol and slow-release aminophylline on exercise tolerance in chronic broiichitis. 7horax 1981;36:787-9."},{"key":"ref_9","first-page":"\"22","article-title":"Sustaincd-relcasc thcophyllinc reduces dvspnea in non-reversible obstruictive airways disease","volume":"131","author":"Mahler, D.A.; Matthay, R.A.; Snyder, P.E.; Wells, C.K.; Ioke, J.","year":"1985","unstructured":"Mahler DA, Matthay RA, Snyder PE, Wells CK, Ioke J. Sustaincd-relcasc thcophyllinc reduces dvspnea in non-reversible obstruictive airways disease..Am Rezv Respir Dis 1985;131:22-5. Ila (utyvatt GH, Townsend M, Pugsley SO, et al. Bronchodilators in chronic air-flow limitation.,Am Rev Respir Dis 1987;135:1069-74.","journal-title":"Am Rezv Respir Dis"},{"key":"ref_10","first-page":"656","article-title":"The efficacy of isoprotercnol inhalation for predicting the response to orally administered theophylline in chronic obstructive pulmonary disease","volume":"126","year":"1982","unstructured":"Dull 'I., Alcxander RR, Sadou] P, Woolson RF. The efficacy of isoprotercnol inhalation for predicting the response to orally administered theophylline in chronic obstructive pulmonary disease. Am Rev Rcspir D)is 1982;126:656-9.","journal-title":"Am Rev Rcspir D)is"},{"key":"ref_11","first-page":"203","article-title":"Theophylline-salbutamol interactioii; bronchodilator response to salbutamol at maximally effective plasma theophylline concentrations. Br7 Clin","volume":"11","year":"1981","unstructured":"Barclay J, Whiting B, Meredith PA, Addis (iJ. 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The influence of theophvllinc oni maximal response to salbtitamol in severe chronic obstructive pulmonary disease. h'ur7 C,lin Pharmacol 1982;22:389-93."},{"key":"ref_13","first-page":"747","article-title":"I'he efficacy of orally administered theophvlline, inhaled salbutamol, and a combinatiotl of the two as chronic therapy in the management of chronic bronchitis with reersiblc air-flow obstruction","volume":"131","author":"D)R, Taylor; B, Buick; C, Kinney; RC, Lowry; DG, McDcvitt","year":"1985","unstructured":"Taylor D)R, Buick B, Kinney C, Lowry RC, McDcvitt DG. I'he efficacy of orally administered theophvlline, inhaled salbutamol, and a combinatiotl of the two as chronic therapy in the management of chronic bronchitis with reersiblc air-flow obstruction. 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Inhaled bitolterol versus sustained release theophyllinc","volume":"139","author":"Zwillich, C.W.; Neaglev, SR, Cicutto; L, White; DP, Miartin; R.J.","year":"1989","unstructured":"Zwillich CW, Neaglev SR, Cicutto L, White DP, Miartin RJ. Nocturnal asthma therapy. Inhaled bitolterol versus sustained release theophyllinc. Am Rev Respir Dis 1989;139:470-4.","journal-title":"Am Rev Respir Dis"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/0002-9343(86)90041-0","article-title":"Treatment of acute asthma","volume":"80","author":"Fanta, C.H.; Rossing, T.H.; McFadden, E.R.","year":"1986","unstructured":"Fanta CH, Rossing TH, McFadden ER. Treatment of acute asthma. 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Auckland: Adis Press, 1984:93-111."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1136\/bmj.281.6244.842","article-title":"Controlled tnral of cromoglycate and slow-release aminophylline in perennial childhood asthma","volume":"281","author":"Edmunds, A.T.; Carswell, F.; Robinson, P.; Hughes, A.O.","year":"1980","unstructured":"Edmunds AT, Carswell F, Robinson P, Hughes AO. Controlled tnral of cromoglycate and slow-release aminophylline in perennial childhood asthma. Br MedJ 1980;281:842.","journal-title":"Br MedJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/0007-0971(79)90026-3","article-title":"A comparison of oral choline theophyllinate and beclomethasone in severe perennial asthma in children","volume":"73","author":"Edmunds, A.T.; McKenzie, S.; Baillie, E.; Tooley, M.; Godfrey, S.","year":"1979","unstructured":"Edmunds AT, McKenzie S, Baillie E, Tooley M, Godfrey S. 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