AntiAsthma Agents

Question 0

Cromolyn (mast cell-stabilizing agent)

Answer 0

NASALCROM
SVN 2omg in 2ml QID (pts older than 2)
start one week before allergen exposure
May take 2-4 weeks

Inhibit mast cell degranulation

Alternate use in ACEI cough

Question 1

Clinical indications for antiasthma drugs

Answer 1

Prophylactic management of mild persistent asthma
CONTROLLER, not RELIEVER.

Cromolyn/antileukotrienes alternative to LDICS
Cromolyn alternative to ICS in children and infants
Antileukotrienes to reduce ICS dose

Question 2

Zileuton (antileukotriene)

Answer 2

ZYFLO (older than 12)
should measure and evaluate hepatic enzymes prior to treatment once a month for first three months.
Can increase serum theophylline concentrations
increase prothrombin time when given with warfarin

Question 3

Zafirlukast

Answer 3

ACCOLATE (older than 5 years)
1 hour before or 2 hours after eating
Bioavailability decreases 40% with food.
Must not exceed doses higher than 40mg/day

Question 4

Montelukast

Answer 4

SINGULAIR (approved for infants 6months of age)

Once a day tablet can be taken with or without food, beverage

Question 5

Role of antileukotrienes in asthma management

Answer 5

Exercise induced asthma, aspirin induced, allergen induced, Chrug-strauss syndrome

Additive effect with ICS

Question 6

Monoclonal antibodies (Omalizumab)

Answer 6

Xolair
subcutaneously injected every 2-4 weeks, slow absorption, half-life of 26 days.

Not replacement for ICS