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  lüll Theophylline in the management of airflow obstruction  2  Difficult drugs to use,  few clinical indications Johnston IDBMJ  1990[Apr]; 300 (6729): 929-31The 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.|Acute Disease[MESH]|Adult[MESH]|Asthma/drug therapy[MESH]|Child, Preschool[MESH]|Chronic Disease[MESH]|Humans[MESH]|Lung Diseases, Obstructive/*drug therapy[MESH]|Theophylline/*therapeutic use[MESH] |