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There is some evidence that caffeine is as effective as theophylline in the short‐term for reducing apnea in premature babies, is better tolerated and is easier to give.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

There is some evidence that theophylline may be more effective for apnea in preterm babies than kinesthetic stimulation, but more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Theophylline may be more helpful in preventing problems for preterm babies with apnea than CPAP (blowing air) through a mask. Apnea is common in preterm babies (born before 37 weeks). It is a pause in breathing of more than 20 seconds, or less than 20 seconds but with a reduced heart rate and cyanosis (a blue tinge to the skin colour indicating not enough oxygen). Resuscitation may be needed. Drugs such as theophylline can be used to stimulate breathing or continuous positive airway pressure (CPAP) which helps breathing by blowing air into the baby through a mask or tube. The review of trials found theophylline is more effective than mask CPAP for preterm infants with apnea. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Theophylline and related drugs, which can enlarge brain blood vessels, are of no apparent benefit in the early treatment of strokes caused by blood clots. Most strokes are caused by a blood clot which then reduces blood flow in the affected part of the brain. Without an adequate blood supply, the brain quickly suffers damage which is often permanent. Drugs which can improve brain blood flow might reduce damage and improve outcome after stroke. Theophylline and related drugs have the ability to alter brain blood flow. This systematic review assesses whether this type of drug improves outcome after stroke. The review identified two small trials, neither of which found any benefit. The limited amount of data mean that there is no evidence at present to suggest that theophylline and related drugs should be used in acute stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Theophylline treatment is commonly used in people with chronic obstructive pulmonary disease (COPD). This systematic review shows that orally administered theophylline improves lung function and levels of oxygen and carbon dioxide in the blood. However, there is limited data on its effect on symptoms, exercise capacity or quality of life. Despite being associated with increased side effects, particularly nausea, participants preferred theophylline over placebo.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Xanthines (e.g. theophylline) are a group of drugs thought to have helpful preventative and reliever properties in the treatment of asthma in children. This review of studies has established that there is evidence for useful effects of these drugs in terms of symptom relief and lung function, but also some evidence of side‐effects. As a primary preventative therapy, whilst there is evidence that xanthines are effective, this review suggests that more effective alternative treatment options (inhaled steroids) are available. In children with more severe asthma, the role of xanthines as an add‐on therapy has only been assessed in a small number of trials, which report mixed effects. More studies in this area would help to generate a more reliable overview of the effects of treatment in these children. Xanthines are an effective preventative treatment in childhood asthma, but less effective than inhaled steroids, and with a less favourable side‐effect profile. There is insufficient evidence at present to assess their role as "add‐on" preventer treatment versus newer alternatives. Some of the trials exposed the children they recruited to a pre‐trial phase of xanthine in order to maintain effective dosing during the trial. This could have made the trial participants less representative of the general population by making them more inclined to tolerate the study drug. This exposure also may have meant that they could recognise what drug they were taking during the blinded phase of the study.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

This review compared three asthma medications, salmeterol, formoterol (both long acting beta‐agonists) and theophylline. These medications are used to help control symptoms of asthma, especially those which occur during the night. This review found that salmeterol showed a greater improvement in lung function, and reduced the need for extra short‐term inhalers in the day and the night. Salmeterol and formoterol are less likely to produce side‐effects (such as headaches and nausea) when compared to theophylline.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Bibliographic details: Fang H, Wang J, Jin D, Cao Y, Xu Y, Xiong W.  Comparison of leukotriene receptor antagonist and theophylline in addition to inhaled corticosteroid in adult asthma: a meta-analysis. Biomolecules and Therapeutics 2011; 19(3): 296-301 Available from: http://tinyurl.com/cm2y6t8

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

PURPOSE: Low-dose theophylline has anti-inflammatory effects. The aim of this study was to evaluate the effects of adding theophylline compared with increasing the dose of inhaled corticosteroid (ICS) on symptomatic asthma.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

There is some evidence that methylxanthines (caffeine and theophylline) are effective in the short‐term for reducing apnoea in premature babies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

BACKGROUND: Radiocontrast nephropathy is a common cause of acute renal failure in hospitalized patients. Several studies have examined the capacity of theophylline or aminophylline to prevent radiocontrast nephropathy, with conflicting results. We conducted a meta-analysis of published randomized controlled trials to determine if the pre-procedural administration of theophylline or aminophylline prevents radiocontrast-induced declines in kidney function.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Lumbar puncture involves getting a sample of spinal fluid though a needle inserted into the lower back. Post‐dural puncture headache (PDPH) is the most common side effect of a lumbar puncture. The symptom of PDPH is a constant headache that gets worse when upright and improves when lying down. Lots of drugs are used to treat PDPH, so the aim of this review was to assess the effectiveness of these drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Bronchiectasis is a lung condition that usually develops after a series of lung problems (such as childhood infections, lung structure problems, tuberculosis, and cystic fibrosis). Mucus (phlegm) collects in the lungs, causing discomfort and infections. Muscle spasms can also narrow the airways (passages to the lungs), causing breathing problems. Drugs to relax the muscles in the airways can help. Methyl‐xanthine drugs (such as caffeine, theophylline and aminophylline) can affect the muscles, and are sometimes used for other lung diseases. They can have adverse effects. The review found there are no trials of the use of methyl‐xanthines for people with bronchiectasis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

There is not enough data to support the routine use of diuretics for respiratory distress syndrome in newborn babies. Diuretics are drugs that increase the production of urine by encouraging salt and water to be released from the kidneys. When newborn babies have respiratory distress syndrome (RDS), their lungs may also contain excess fluid that can cause breathing problems. Babies with RDS sometimes may also have a reduced urine output. Using diuretics in these babies may improve lung or kidney function transiently, but may also increase cardiovascular complications. The review of trials did not find enough evidence supporting the routine use of diuretics in these infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Methylxanthine drugs such as aminophylline and theophylline are recommended for use in patients who have acute exacerbations (episodes) of chronic obstructive pulmonary disease, particularly for patients unresponsive to standard therapies. This review identified four studies that compared these drugs with placebo. Over the first 2 hours of treatment there was no evidence that patients improved in terms of lung function, although a possible late benefit was detected. The studies do not give a clear indication of whether there was benefit in terms of reduced symptoms or hospital admissions, but side effects were found to be more common with methylxanthines. We conclude that, given current evidence, methylxanthines should not be used for acute exacerbations of chronic obstructive pulmonary disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Apnea is a pause in breathing of greater than 20 seconds. It may occur repeatedly in preterm babies (born before 34 weeks). Methylyxanthines (such as theophylline and caffeine) are drugs that are believed to stimulate breathing efforts and have been used to reduce apnoea. It has been suggested that preterm babies with apnoea should receive prophylactic caffeine as a preventative measure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Doxapram and methylxanthine stimulate breathing in infants with apnea. Infant apnea is a pause in breathing of greater than 20 seconds. This can be harmful to the developing brain and cause dysfunction of the gastrointestinal tract or other organs. Drugs such as doxapram and methylxanthine are thought to stimulate breathing and are given to reduce apnea. The review of four small trials found that there was no large difference between the drugs in the short term. There is not enough evidence to exclude a small difference in benefit, long term effects or a difference in less common adverse effects. More research is needed into the long term and adverse effects of these drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

We reviewed the evidence about the effect of quinine on muscle cramps.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

OBJECTIVE: To examine the effect of prophylactic theophylline for the prevention of severe renal dysfunction in post-asphyxiated term and post-term infants.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Asthma is the most common disorder of the respiratory system (the organs that help you breathe) in pregnancy, affecting up to one in eight women. During pregnancy asthma can improve, worsen or remain unchanged. Poorly controlled asthma may lead to complications for mothers including pre‐eclampsia (high blood pressure and protein in the urine), gestational diabetes (high blood glucose) and caesarean birth; complications for babies may include death, preterm birth (before 37 weeks of pregnancy) and being born low birthweight. Maintaining adequate control of asthma during pregnancy, including effective management and prevention of exacerbations, is the goal of management. In pregnancy, women may be concerned about risks of taking medications, and their health professionals may be uncertain about best management strategies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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