Paradoxic bronchoconstriction is a problem with the anti-cholinergics. Any time you spray a Anti-inflammatory therapy, mainly the steroids is what I am talking about. Moraxella catarrhalis and Strep pneumonia are also common pathogens. These are antibiotics which are effective. Let s move on to theophylline.
Theophylline has significant benefits listed here.
The problem is it has significant risks narrow therapeutic window, lots of GI problems and variable metabolism interaction with other medications. If you are going to use Mucoactive agents, I will tell you there aren t any that really work very well except for alpha-dornase. This is the DNAase that we use in cystic fibrosis patients. It works very well in those patients. They had to stop the study in the chronic bronchitis patients because there was an increased mortality that was unexplained.