VIEWS & REVIEWS

Theophylline still has a place in COPD Reports of a high frequency of theophylline

toxicity have lead some authors to advocate that the drug should no longer be prescribed for ambulatory patients with chronic obstructive pulmonary disease (COPD). However, Dr GL Snider from the US, believes that this is an 'overreaction'.

In his review, Dr Snider points out that, because of the log-linear relationship between the bronchodilating effect of theophylline and the blood level of the drug, 'little therapeutic efficacy is lost by targeting a lower blood level', such as 10 I1g/ml, rather than the often recommended 17-20 I1g/ml. In this way, the therapeutic range of the drug is increased.

Dr Snider adds that because theophylline has a different mode of action to I3ragonist and anticholinergic aerosols, it still has a role in the management of COPD. Snider GL. Theophylline in the ambulatory treatment of chronic obstructive lung disease: resolving a controversy. Cleveland Clinic Journal of Medicine

60: ',}7 ·201 . May-Jun 1993 """"""

ISSN 0156-2703l93l0626-OO5lS1 .aac Adla'nlenwtlonellld

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'NPHARMA~ 26 Jun 1993