Should aminophylline be abandoned in the treatment of acute asthma in adults?
Intravenous aminophylline is widely used for the treatment of acute asthma and anecdotes about its apparent effectiveness abound. Early studies demonstrated that aminophylline is an inefficient bronchodilator compared with adrenergic agonists given by injection or inhalation. This paper presents the results of a review of randomized controlled trials examining the effect of adding aminophylline to standard modern therapy with a nebulized beta(2) agonist and systemic corticosteroids in acute asthma in adults. Six of the seven trials, comprising 343 patients, failed to demonstrate any beneficial effect of aminophylline. Furthermore, minor toxicity was common. There is presently no evidence to support the use of aminophylline in addition to standard therapy for acute asthma in adults.
Hart
S P
SP
Respiratory Medicine Unit, Western General Hospital, Edinburgh, UK. whart@globalnet.co.uk
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D000628:Aminophylline / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D013147:Spirometry; D013256:Steroids; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D013256:Steroids; D000628:Aminophylline