Assess for concomitant diseases It is well accepted that certain diseases exacerbate asthma. In my practice allergic rhinitis, chronic sinusitis, and gastroesophageal reflux disease are common among asthmatic patients. I therefore find it useful to ask about postnasal drip, purulent…
Asthma Management
Leukotriene-receptor antagonists. Pharmacologic considerations
Pharmacokinetics of montelukast (Singulair) Montelukast (marketed as Singulair) is rapidly and nearly completely absorbed following oral administration. Peak plasma concentrations are reached in 2 to 3 hours for the 5- and 10-mg formulations. Mean plasma half-life is 2.7 to 5.5…
Questions to Ask Your Physician about Allergies and Asthma
1. How do I know whether I have allergies or asthma? 2. If I have no family history of allergies or asthma, is it true that I won’t get them? 3. How old does a child have to be before…
Asthma Management: Quick-Relief Medications
The medications used for quick relief of bronchoconstriction and immediate reversal of airflow obstruction include short-acting beta2-agonists, anticholinergic agents, and systemic corticosteroids. TABLE 2 itemizes the advantages and disadvantages of the quick-relief medications that are used for the treatment of…
Management of Asthma in Children: Chronic Asthma – Preventing Asthma Exacerbations
Medications used in children to control asthma symptoms and to prevent exacerbations include inhaled corticosteroids (ICSs), leukotriene receptor antagonists (LTRAs) (or leukotriene modifiers in the older children), long-acting beta2-agonists (LABAs), theophylline, and cromolyn. No daily medications are needed for mild…
Leukotriene-receptor antagonists. Clinical models of asthma
Allergen-induced asthma In sensitized patients, inhalation of a specific allergen results in acute bronchoconstriction that usually subsides spontaneously within 2 hours; this phenomenon is known as the early asthmatic response. In many asthma patients, the early response resolves only to…
Management of Asthma in Children: Treatment Considerations
Levalbuterol Versus Albuterol Sometimes children or their caregivers are intolerant of albuterol’s side effects, namely palpitations, tremors, hyperactivity, insomnia, and tachycardia. Levalbuterol (Xopenex), the (r)-enantiomer of racemic albuterol, was first introduced in 1999 and was subsequently FDA approved in 2002…
Chronic Asthma Management
Traditionally, asthma has been treated with oral and inhaled bronchodilators, which help control the symptoms of asthma but do nothing for the inflammation. Now, the focus is on prevention, which involves treating the underlying inflammation as well as the bronchoconstriction,…
Lifestyle Changes and Non-Drug Treatment
Your physician is very likely to talk with you about ways to prevent asthma attacks or to reduce their frequency. Likewise, people with chronic obstructive pulmonary (lung) disease (COPD) can make changes that will reduce their breathing difficulties and slow…
Management of Asthma in Children: Asthma Education
Although millions of prescriptions are filled each year for asthma medications, Lozano et al demonstrated that the insured population who are prescribed controller medications exhibit inadequate control. Thus, pharmacists should intervene proactively and offer education as appropriate. Pharmacists in all…