Jiří Slíva M.D.
Absolute number of patients suffering from AB in Czech. Rep.
Period
Number of patients
THE MOST IMPORTANTALERGENES
JANUARY
FEBRUARY
MARCH
APRIL
MAY
1. DEC. 2. DEC. 3. DEC. Pollen situation of„Alnusglutinosa“ in the Europe
DIAGNOSIS
1. ANAMNESIS
3. LABORATORYTESTS
2. CLINICALFEATURES
4. ALLERGOLOGICAL TESTS
own pharmacoterapylife style
specific imunotherapy
symptomaticantiinflammatoric
preventive
• sympatomimetics
• anticholinergics
• corticosteroides
• methylxantines
• antileucotriens
• antihistamines
Groups of drugs:
β-mimetics
- nonselective - adrenaline, isoproterenol, orciprenaline, ephedrine
- selective - metaproterenol, albuterol, salbutamol, terbutalin, fenoterol => more effective via inhalation then per os administration => increase of cAMP
Parasympatolytics
ipratropium
Antiasthmatics with rapid effect:
theophylline - myotropic influence via inhibition of phosphodiesterase and via influence on the adenosine receptors A2
=> bronchodilatation
=> prevention from bronchoconstriction caused by histamine, cholinergic agonists (metacholine) or exertion.
Aminophylline = theophylline + ethylendiamine
Methylxantines:
inhibition of degranulation of mastocytes after exposition to specific agents full effect after 4-6 weeks
Drugs used for prevention and maintained treatment:
cromoglycate sodium
nedocromil• similar to cromoglycate in mechanism of action
β2-mimetics with long-term effect:
• via inhalation salmeterol and formoterol • via per os ( tabl, sirup) klenbuterol, prokaterol, salbutamol
Teophylline with prolonged releasing
zafirlukast zileuton montelukast
Antileucotriens =
Leucotriene Receptor Antagonists (LTRAs):
beklometasone budesonide flunisolide fluticasone triamcinolone
potent antiinflammatory effect
decrease of number of inflammatory potent
cells
inhibition of bronchoconstrictory mechanisms
direct relaxation of smooth muscle cells
Corticosteroids:
astemizole (Hismanal) clemastineterphenadineketotifen (Zaditen)
reversible competitive antagonists of H-receptors
Antihistamines:
verapamile (Isoptin) nifedipine others
inhibition of calcium influx => inhibition of contraction of smooth muscle cells
induction of bronchodilatation
used experimentaly
Inhibitors of calcium channels:
Comparison of numbers of drugs used in therapy of bronchial asthma
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