Chronic Asthma Management: Concomitant Diseases. Action Plan

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…

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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…

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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…

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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…

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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…

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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…

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Management of Asthma in Children: Diagnosis and Clinical Presentation

Although 50% to 80% of people with asthma develop symptoms before age 5, many children are misdiagnosed with reactive airway disease, allergic bronchitis, wheezy bronchitis, asthmatic bronchitis, recurrent pneumonia, or recurrent bronchiolitis. Asthma is diagnosed after a young child has…

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