Which medications in the drug class Xanthine Derivatives are used in the treatment of Status Asthmaticus?

Updated: Jun 17, 2020
  • Author: Constantine K Saadeh, MD; Chief Editor: John J Oppenheimer, MD  more...
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Xanthine Derivatives

These agents are used as additional therapy for patients who remain in refractory status asthmaticus despite maximal inhalational therapy and the use of corticosteroids. These medications may be administered intravenously.

Theophylline (Theo-24, Elixophyllin Elixir)

Theophylline is a bronchodilator that is used in patients with reversible bronchospasm associated with asthma or chronic obstructive pulmonary disease. The mechanism of action of theophylline is unclear, but its beneficial effects in asthma are thought to result from bronchodilation partly caused by phosphodiesterase inhibition, improved diaphragmatic inotropicity, CNS stimulation of the respiratory drive, and possible anti-inflammatory effects.

Start oral (eg, Theo-24, Theochron, Elixophyllin Elixir) dosing when the patient is stable on continuous IV dose.


Aminophylline causes bronchodilation by increasing tissue concentrations of cAMP. It can be administered intravenously. However, intravenous aminophylline is generally used for refractory status asthmaticus because of the severity of the patient's asthma, which results in the decision to add methylxanthines to the treatment regimen. The theophylline dose is 79% of the aminophylline dose. To convert a theophylline dose to aminophylline, the theophylline dose needs to be divided by 0.80.

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