asthma medical treatment
TRANSCRIPT
THEY ARE CHROMONE DERIVATIVES THAT BLOCK
CHLORIDE CHANNELS ESSENTIAL FOR MAST CELL DEGRANULATION
WHICH INTURN STABILIZE THE MAST CELL
-PREVENTING HISTAMINE RELEASE & RELATED MEDIATORS
KETOTIFEN
ANTIHISTAMINIC
WITH
CROMOGLYCOL
ATE LIKE
ACTION
NOT A
BRONCHO DILATOR
PRODUCESSEDATION
SYMPTOMATIC RELIEF IN
1.ATOPIC DERMATITIS
2.PERENNIAL RHINITIS
3.CONJUNCTIVITIS
4.URTICARIA
5.FOOD ALLERGY
ABSORBED ORALLYBIOAVAILIBILITY: 50%
T1/2 : 22HOURS
LEUKOTRIENESFATTY COMPOUNDS
PRODUCED BY IMMUNE
SYSTEM THAT CAUSE
INFLAMMATION IN ASTHMA &
BRONCHITIS , & CONSTRICTS
AIRWAYS
• BROCHODILATATION
• REDUCED SPUTUM EOSINOPHIL COUNT
• SUPPRESION OF BRONCHIAL INFLAMMATION
• MILD TO MODERATE ASTHAMA:
ALTERNATIVE TO INHALED
GLUCOCORTICOIDS
• SEVERE ASTHMA: PERMIT STEROID
DOSE
REDUCTION &
RESCUE B2
AGONIST INHALATION
• WELL ABSORBED ORALLY
• HIGHLY PLASMA PROTEIN BOUND
• PLASMA T1/2 : 3-6HOURS(MONTELUKAST)
• PLASMA T1/2 : 8-12 HOURS(ZAFIRLUKAST)
ZILEUTON
5-LOX INHIBITOR
BLOCKS LTC4/D4/B4 SYNTHESIS
CLINICAL EFFICACY SIMILAR TO MONTELUKAST
SHORT ACTION
HEPATOTOXIC POTENTIAL
RESTRICTED USE
• GLUCOCORTICOIDS ARE STEROID
HORMONES
• ANTI-INFLAMMATORY
• PREVENT PHOSPHOLIPID RELEASE
• DECREASE EOSINOPHIL ACTION
TYPE OF THERAPY
SYSTEMIC STEROID THERAPY
INHALED STEROIDS
PREDNISOLONE BUDESONIDE
BECLOMETHASONE DIPRPIONATE
1. SEVERE CHRONIC
ASTHMAWHEN NOT CONTROLLED BY
BROCHODILATORS/INHALED STEROIDS
START PREDNISOLONE 20-60Mg/DAY
2. STATUS ASTHMATICUSHIGH DOSE I.V. GLUCOCORTICOID, ACT IN
6-24 HRS
INHALED STEROIDS
O HIGH TOPICAL LOW SYSTEMIC
ACTIVITY
O SHOULD BE ‘STEP 1’ FOR ALL ASTHMA
PATIENTS
O INDICATED WHEN B2 AGONIST
REQUIRED DAILY
O START 100-200 mg BD
EFFECT
O SUPRESS BRONCHIAL INFLAMMATION
O INCREASE PEAK EXPIRATORY FLOW
RATE
O NO ROLE IN ACUTE ATTACK
O PEAK EFFECT IN 4-7 DAYS
O DOESN’T PRECIPITATE ASTHMA,
MUUSCULAR PAIN, LASSITUDE,
DEPRESSION, HYPOTENSION
IN COPD
O HIGH DOSE INHALED STEROIDS
BENEFICIAL ONLY IN ADVANCED
CASES
O NO PROOF THAT THEY SLOW
DISEASE PROGRESSION
ADVERSE EFFECT
HOARSENESS OF VOICE
SYMPTOMATIC OROPHARYNGEAL CANDIDIASIS
SYSTEMC EFFECT AT >600 mg
DOSE/DAY
• MOOD CHANGES
• OSTEOPOROSIS
• BRUISING
• PETECHIAE
• PITUITARY-ADRENAL SUPPRESION
DYSPHONIA