Bronchodilator therapy in obstructive lung disease.

In recent years the management of patients with obstructive lung disease has been greatly simplified by the introduction of highly selective long-acting beta adrenergic agonists, slow release theophylline preparations and locally active anticholinergic agents. The beta adrenergic compounds are the most potent and many feel that they should be the first line therapy for acute episodes of airway obstruction. Methylxanthines continue to be used effectively in chronic disease and the improved bloodlevel time profiles of theophylline that are now available from sustained-release formulations provide better control of symptoms with fewer side effects than was previously possible. The new anticholinergic compounds currently undergoing testing show great promise in selected clinical situations.