asthma medical treatment
MAST CELL STABILIZERS BY Mr. Kanishk Deep Sharma MAST CELL STABILIZERS THEY ARE CHROMONE DERIVATIVES THAT BLOCK CHLORIDE CHANNELS ESSENTIAL FOR MAST CELL DEGRANULATION Sodium cromoglycate Ketotifen Sodium cromoglycate ADVERSE EFFECT KETOTIFEN ANTIHISTAMINIC WITH CROMOGLYCOLATE LIKE ACTION ADVERSE EFFECT LEUKOTRIENE ANTAGONISTS LEUKOTRIENES THEY ANTAGONISE RECEPTOR CYSLT1 ADVERSE EFFECT ZILEUTON CORTICOSTEROIDS SYSTEMIC STEROIDS USED IN 2 SITUATIONS SEVERE CHRONIC ASTHMA STATUS ASTHAMATICUS SEVERE CHRONIC ASTHMA WHEN NOT CONTROLLED BY BROCHODILATORS/INHALED STEROIDS START PREDNISOLONE 20-60Mg/DAY STATUS ASTHMATICUS HIGH DOSE I.V. GLUCOCORTICOID, ACT IN 6-24 HRS INHALED STEROIDS HIGH TOPICAL LOW SYSTEMIC ACTIVITY SHOULD BE ‘STEP 1’ FOR ALL ASTHMA PATIENTS INDICATED WHEN B2 AGONIST REQUIRED DAILY START 100-200 mg BD EFFECT SUPRESS BRONCHIAL INFLAMMATION INCREASE PEAK EXPIRATORY FLOW RATE NO ROLE IN ACUTE ATTACK PEAK EFFECT IN 4-7 DAYS DOESN’T PRECIPITATE ASTHMA, MUUSCULAR PAIN, LASSITUDE, DEPRESSION, HYPOTENSION IN COPD HIGH DOSE INHALED STEROIDS BENEFICIAL ONLY IN ADVANCED CASES NO PROOF THAT THEY SLOW DISEASE PROGRESSION ADVERSE EFFECT EXAMPLES BUDESONIDE BECLOMETHASONE DIPRPIONATE FLUTICASONE PROPIONATE FLUNISOLIDE CICLESONIDE THANK YOU
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asthma medical treatment
- 1. MAST CELL STABILIZERS BY Mr. Kanishk Deep Sharma LEUKOTRIENE ANTAGONISTS CORTICOSTEROIDS
- 3. THEY ARE CHROMONE DERIVATIVES THAT BLOCK CHLORIDE CHANNELS ESSENTIAL FOR MAST CELL DEGRANULATION WHICH INTURN STABILIZE THE MAST CELL -PREVENTING HISTAMINE RELEASE & RELATED MEDIATORS
- 8. KETOTIFEN ANTIHISTAMINIC WITH CROMOGLYCOL ATE LIKE ACTION NOT A BRONCHO DILATOR PRODUCES SEDATION SYMPTOMATIC RELIEF IN 1.ATOPIC DERMATITIS 2.PERENNIAL RHINITIS 3.CONJUNCTIVITIS 4.URTICARIA 5.FOOD ALLERGY ABSORBED ORALLYBIOAVAILIBILITY: 50% T1/2 : 22HOURS
- 11. LEUKOTRIENES FATTY COMPOUNDS PRODUCED BY IMMUNE SYSTEM THAT CAUSE INFLAMMATION IN ASTHMA & BRONCHITIS , & CONSTRICTS AIRWAYS
- 14. • 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
- 15. • WELL ABSORBED ORALLY • HIGHLY PLASMA PROTEIN BOUND • PLASMA T1/2 : 3-6HOURS(MONTELUKAST) • PLASMA T1/2 : 8-12 HOURS(ZAFIRLUKAST)
- 17. ZILEUTON 5-LOX INHIBITOR BLOCKS LTC4/D4/B4 SYNTHESIS CLINICAL EFFICACY SIMILAR TO MONTELUKAST SHORT ACTION HEPATOTOXIC POTENTIAL RESTRICTED USE
- 19. • GLUCOCORTICOIDS ARE STEROID HORMONES • ANTI-INFLAMMATORY • PREVENT PHOSPHOLIPID RELEASE • DECREASE EOSINOPHIL ACTION
- 20. TYPE OF THERAPY SYSTEMIC STEROID THERAPY INHALED STEROIDS PREDNISOLONE BUDESONIDE BECLOMETHASONE DIPRPIONATE
- 21. SYSTEMIC STEROIDS O USED IN 2 SITUATIONS 1. SEVERE CHRONIC ASTHMA 2. STATUS ASTHAMATICUS
- 22. 1. SEVERE CHRONIC ASTHMA WHEN NOT CONTROLLED BY BROCHODILATORS/INHALED STEROIDS START PREDNISOLONE 20-60Mg/DAY 2. STATUS ASTHMATICUS HIGH DOSE I.V. GLUCOCORTICOID, ACT IN 6-24 HRS
- 23. 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
- 24. 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
- 25. IN COPD O HIGH DOSE INHALED STEROIDS BENEFICIAL ONLY IN ADVANCED CASES O NO PROOF THAT THEY SLOW DISEASE PROGRESSION
- 26. ADVERSE EFFECT HOARSENESS OF VOICE SYMPTOMATIC OROPHARYNGEAL CANDIDIASIS SYSTEMC EFFECT AT >600 mg DOSE/DAY • MOOD CHANGES • OSTEOPOROSIS • BRUISING • PETECHIAE • PITUITARY-ADRENAL SUPPRESION DYSPHONIA
- 27. EXAMPLES OBUDESONIDE OBECLOMETHASONE DIPRPIONATE OFLUTICASONE PROPIONATE OFLUNISOLIDE OCICLESONIDE
- 28. THANK YOU