Management of Asthma and Chronic Airflow Limitation (Part 2)

Intravenously administered aminophylline still is widely used, usually together with inhaled, or less commonly, systemically administered adrenoceptor agonists, in the initial treatment of patients presenting to the emergency room with an acute exacerbation of asthma — buy asthma inhaler. In this setting, is the use of aminophylline beneficial or necessary? This question was subjected to scrutiny in a recent meta-analysis. In this study, 347 clinical trials, published between 1966 and 1986, were analyzed. Of these, only 13 were judged to be of acceptable design for final analysis. These 13 studies compared aminophylline therapy with a control regimen consisting of albuterol (salbutamol), epinephrine or other sympathomimetic bronchodilators. Of these, three favored aminophylline, three favored the control regimen and seven showed no difference between the two. When the results from all 13 studies were pooled and re-analyzed, there was no difference between the aminophylline-treated group and the control groups. Moreover, several of the studies emphasized that side effects such as tremor, nausea, anxiety and palpitations occurred more often, and at times, exclusively, in the aminophylline-treated patients.
One of the most recent studies included in the meta-analysis was that of Siegel and colleagues. In this carefully conducted trial, the efficacy of a 3-h intravenous infusion of aminophylline, as part of a therapeutic regimen, was compared with that of placebo in patients presenting with severe acute exacerbations of asthma.