To the Editor.—
Bierman et al (234: 295,1975) suggest that ephedrine and theophylline in combination have an additive effect in suppressing exercise-induced bronchospasm. On examination of these data, however, I am more impressed with the relative lack of suppression of exercise-induced bronchospasm that was obtained even with the combination product. It certainly does not compare with the far more impressive blocking of exercise-induced bronchospasm that can be achieved with an inhaled sympathomimetic amine1 or with theophylline administered in doses that achieve therapeutic serum concentrations of 10μg/ml to 20μg/ml.2The data of Bierman et al demonstrate mild bronchodilation (an 11% increase in the forced expiratory flow (FEF) 25% to 75%) during the preexercise period after the administration of a theophylline-ephedrinehydroxyzine hydrochloride mixture had been followed by a 19% postexercise drop in the FEF25%-75%. By comparison, exercise resulted in only a 25% fall in FEF25%-75% after the administration
Weinberger M. Exercise-induced Asthma. JAMA. 1976;236(5):447–448. doi:10.1001/jama.1976.03270050011007
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