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July 1, 2009 | Leave a Comment
Asthma
Bronchial asthma is a spasmodic obstructive disease of the airways, and symptoms may vary from wheeziness to severe bronchoconstriction that can be fatal. Attacks may be precipitated by exposure to allergens, which may vary from house dust to pollen, fungal spores and animal hair. In some susceptible patients certain drugs,
including aspirin, may initiate a severe asthmatic attack. Treatment is basically with
drugs that have a relatively selective bronchodilatory action, and, in the case of those
drugs given by aerosol inhalation, patients must be given careful instruction in the optimum response is to be obtained. Ephedrine and
use of the inhaler device if the optii
isoprenaline have been used in asthma, but have been virtually replaced by salbutamol and other more selective P,-adrenoceptor stimulants. Adrenaline also has a powerful bronchodilator action, but it may cause cardiac arrhythmias, and it is now used mainly in acute anaphylaxis. (See page 10.)
Salbutamol, now widely used, may be given orally by aerosol inhalation, or, in acute conditions, by injection. Ipratropium and oxitropium are anticholinergic agents with a relatively selective bronchodilator action, and are of value in patients who cannot tolerate sympathomimetic agents of the salbutamol type. Other bronchodilators are the xanthines aminophylline and theophylline, but side-effects
Some long-acting may limit their use. ome xanthine products have a sustained action associated with reduced side-effects, but such products are not necessarily bioequivalent, and a change from one product to another should not be made without good cause. Corticosteroids are also of value in both the prophylaxis and treatment of asthma, and those given by inhalation are beclomethasone, budesonide and fluticasone. The recently introduced salmeterol is a derivative of salbutamol intended for use together with inhaled corticosteroid therapy in the prophylactic treatment of asthma. It has a slow initial action, but twice daily treatment is claimed to give relief over 24 hrs. Other drugs for the prophylaxis of asthma are sodium cromoglycate and nedocromil, given by oral inhalation of a dry powder. Ketotifen is an antihistamine with some of the properties of sodium cromoglycate.
Approved names Brand names
bambuterol Bambec
eformoterol Foradil
fenoterol Berotec:
reproterol Bronchodil
salbutamol Salbulin,
Ventolin, Volmax
Aerolin Autohaler, aerosol inhalation Salbulin, Ventolin products
salmeterol Serevent
terbutaline Bricanyl, Monovent
tulobuterol Respacal other stimulat
orciprenaline Alupent
oxitropium Oxivent
xanthines
aminophylline Pecram, Phyllocontin Continua 119
theophylline Choledyl, Lasma, Nuelin,
Slo-Phyllin, Theo-Dur, Uniphyllin
beclomethasone Becotide, Becodisks, Becloforte
budesonide Pulmicort
fluticasone Flixotide
sodium Intel cromoglycate
ketoprofen Zaditen
nedocromil Tilade anticholinergic agents
pratroplum Atrovent
oxitropium Oxivent
Tags:
acute conditions,
adrenaline,
adrenoceptor,
aerosol inhalation,
alchohol,
aminophylline,
anticholinergic agents,
aspirin,
Asthma,
asthmatic attack,
beclomethasone,
Bronchial,
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bronchoconstriction,
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Treatment,
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