BMJ  2006;332:1497-1499 (24 June), doi:10.1136/bmj.332.7556.1497

Practice

ABC of chronic obstructive pulmonary disease

Pharmacological management—oral treatment

Graeme P Currie, specialist registrar

Respiratory Unit, Aberdeen Royal Infirmary, Aberdeen.

Daniel K C Lee, specialist registrar

Department of Respiratory Medicine, Papworth Hospital, Papworth Everard, Cambridge.

Brian J Lipworth, professor

Asthma and Allergy Research Group, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee.

The first 150 words of the full text of this article appear below.

Inhaled treatment forms the cornerstone of drug management of chronic obstructive pulmonary disease (COPD). However, some patients—especially those who are elderly, cognitively impaired, or with upper limb musculoskeletal problems—are unable to use inhaler devices successfully.


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 Some patients may not have the manual dexterity required to use hand held inhaler devices. Unfortunately, there are significant unmet needs in terms of effective, long acting, oral bronchodilators for COPD

 

Theophylline is one of the oldest oral bronchodilators available for the treatment of COPD. It has a similar chemical structure to caffeine, which is also a bronchodilator in large amounts.


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  		Additive effects of theophylline and the bronchodilator salmeterol on lung function in patients with COPD at day 1 and at 12 weeks after starting treatment

 

Theophylline is a non-selective phosphodiesterase inhibitor, and it causes an increase in the intracellular concentration of cyclic AMP in various cell types and organs (including the lung). Increased cyclic . . . [Full text of this article]


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