Академический Документы
Профессиональный Документы
Культура Документы
Anti-cholinergics
1. Ipratropium bromide
II. Controllers
- Treat the underlying inflammation (and/or cause prolonged
bronchodilation)
- Decreases symptoms (mucosal swelling, secretions, irritability of
bronchial smooth muscle)
- Taken: regularly (even when well)
- For: All asthmatics, EXCEPT mild intermittent
Inhaled Corticosteroids:
1. Beclomethasone
2. Budesonide
3. Fluticasone
Oral Corticosteroids:
1. Prednisone
2. Prednisolone
3. Methylprednisone
4. Methylprednisolone
Leukotriene modifiers:
1. Montelukast
2. Zafirlukast
Long-acting agonists:
1. Salmeterol
2. Formoterol
Attacks of asthma precipitated by aspirin like drugs are due to the inhibition
of COX in airways of the sensitive patients.
The two major enzymes in the COX pathway are cyclo-oxygenase 1 and 2
(COX-1 and COX-2 respectively). Most of the evidence suggests that inhibition
of COX-1 is related to the pathogenesis of AIA (Aspirin Induced Asthma) in
patients sensitive to aspirin. It is thought that this inhibition causes a
deficiency in the protective bronchodilator/anti-inflammatory prostaglandins,
and an excess of pro-inflammatory/bronchoconstrictive leukotrienes,
specifically cysteinyl-leukotrienes.
Treatment:
Oxygen
Inhaled albuterol;
Intravenous or oral corticosteroids (Hydrocortisone hemisuccinate)
Inhaled anticholinergics (Ipratropium bromide)
Antibiotics
IV saline