Q: I am 25 years old female. My doctor has prescibed Unicontin 400 to help my cough. Does it mean that I have asthma? Is it something which will continue for the whole of my life?

A:The first step is to diagnose the cause of cough and then offer treatment. There are so many reasons for cough. Unless a diagnosis of asthma is firmly and correctly made, one should never prescribe anti-asthmatic medicines since they need to be taken for very long duration, if not permanently. Unicontin Continus 400 is the brand name of a sustained release preparation of theophylline which is used in asthma and chronic bronchitis. It has one major problem: overdose can quickly lead to toxicity such as loss of appetite, nausea, agitation, anxiety, heart movement abnormalities etc. Hence every overdose is to be regarded as potentially fatal. In order to avoid such an eventuality, it is always recommended that the level of the drug in blood should be regualry monitored and must not be allowed to exceed 20microgram, per ml. Even in confirmed cases of asthma (after testing with spirometry), the first line therapy should always be those medicines which are inhaled (such as salbutamol, terbutaline etc), rather than taken by mouth, so that medicine reaches the lungs straightaway. Only in a few cases it becomes necessary to use theophylline, that too, when other treatments are not producing adequate response.