Not useful in acute attack. Using a spacer device with a metered-dose inhaler increases efficacy. There have been reports of diminished response to beta-agonists with chronic use, especially overuse. Inhaled beta-agonists give better bronchodilatation with less systemic side effects than oral preparations have. However, it is not useful in treating an acute attack of asthma.
Theophylline has a long duration of action when given as the sustained-release preparation.
May produce additional bronchodilatation when used in combination with a beta-agonist. IV aminophylline is not recommended in the emergency treatment of acute asthma. Dose should be adjusted by serum levels. Monitor levels carefully if using in combination with cimetidine, quinolones, erythromycin, other drugs. GI symptoms, seizures, CNS stimulation, tachycardia, arrhythmias can occur with toxicity.