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Analgesic sensitivity in children with asthma.

M Weinberger

    Pediatrics
    |November 1, 1978
    PubMed
    Summary

    Aspirin sensitivity is common in chronic asthma patients, including children. Certain anti-inflammatory drugs can trigger airway obstruction in these individuals, possibly through prostaglandin and histamine pathways.

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    Area of Science:

    • Pharmacology
    • Pulmonology
    • Immunology

    Background:

    • Aspirin sensitivity, initially linked to a triad of nonallergic asthma, nasal polyps, and asthma, is now recognized in broader asthma populations.
    • Its prevalence in pediatric asthma patients is higher than previously understood.
    • This sensitivity involves reactions to nonsteroidal anti-inflammatory drugs (NSAIDs).

    Purpose of the Study:

    • To review the incidence and implications of aspirin sensitivity in chronic asthma.
    • To examine the range of NSAIDs that trigger airway obstruction in sensitive individuals.
    • To explore the potential mechanisms underlying aspirin-induced bronchospasm.

    Main Methods:

    • Literature review of studies on aspirin sensitivity and asthma.
    • Analysis of drug-induced airway obstruction in aspirin-sensitive asthmatics.
    • Examination of proposed biochemical pathways, including prostaglandin and histamine involvement.

    Main Results:

    • Aspirin sensitivity is a frequent comorbidity in chronic asthma, affecting adults and children.
    • NSAIDs like indomethacin frequently cause airway obstruction; phenylbutazone has a lesser effect.
    • Acetaminophen's effects are inconsistent, while salicylic acid and salicylamide appear tolerated.
    • A correlation is suggested between NSAID-induced airway obstruction and in vitro prostaglandin synthetase activity.
    • Elevated plasma histamine levels during pulmonary reactions have been observed.

    Conclusions:

    • Aspirin and related analgesics can mediate bronchospasm in sensitive asthma patients.
    • Mechanisms likely involve effects on prostaglandin production, cyclic nucleotide activity, and subsequent histamine release from mast cells.
    • Understanding these mechanisms is crucial for managing asthma in patients with drug sensitivities.

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