Assessment of acute asthma in the emergency room: evaluation of compliance and combined drug therapy.

Thirty-three chronic asthmatic children and adolescents on predetermined doses of theophylline preparations who arrived at the Emergency Room with an acute episode of wheezing were evaluated to determine compliance, and if therapeutic plasma theophylline levels (PTLs) facilitate the effectiveness of epinephrine. Patients were divided into three groups based on the requirement of one, two, or three doses of epinephrine. In the total group of patient visits, only 25% took the theophylline preparations as prescribed. The poor responders group requiring three injections of epinephrine was characterized by the lowest compliance and the highest unacceptable PTLs. It appears that therapeutic PTLs enhance the response to epinephrine. The evaluation of compliance in case of epinephrine failure is recommended.