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Related Concept Videos

Antiasthma Drugs: Leukotriene Modifiers01:19

Antiasthma Drugs: Leukotriene Modifiers

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Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
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Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

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Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
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Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs01:25

Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs

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Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
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COPD: Management Using Bronchodilators and Corticosteroids01:26

COPD: Management Using Bronchodilators and Corticosteroids

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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Antiasthma Drugs: Methylxanthines01:24

Antiasthma Drugs: Methylxanthines

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Theophylline, a member of the methylxanthine class of bronchodilators, has long been used in asthma management. While its exact mechanism of action is not fully understood, it is believed to have multiple effects on various cellular processes.
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
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Asthma-IV: Diagnostic and Management01:30

Asthma-IV: Diagnostic and Management

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The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
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Methodology for Sputum Induction and Laboratory Processing
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Macrolides versus placebo for chronic asthma.

Krishna Undela1, Lucy Goldsmith2, Kayleigh M Kew3

  • 1Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research Guwahati, Assam, India.

The Cochrane Database of Systematic Reviews
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PubMed
Summary
This summary is machine-generated.

Macrolide antibiotics likely reduce asthma exacerbations requiring hospitalization and emergency visits. While some symptom improvement is noted, the overall evidence quality is low, necessitating further research.

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Area of Science:

  • Respiratory Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Asthma is a chronic inflammatory airway disease characterized by wheezing, coughing, and breathing difficulties.
  • Macrolides, antibiotics with anti-inflammatory properties, are being investigated for long-term asthma management.

Purpose of the Study:

  • To evaluate the efficacy of macrolides compared to placebo in managing chronic asthma.
  • To assess macrolides' impact on asthma exacerbations, symptoms, and quality of life.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) involving macrolides versus placebo for at least four weeks.
  • Inclusion of studies on both children and adults with asthma.
  • Primary outcomes included hospitalizations, severe exacerbations, symptom scores (ACQ, AQLQ), rescue medication use, and lung function (PEF, FEV1).

Main Results:

  • Macrolides likely reduce asthma exacerbations requiring hospitalization (moderate-certainty evidence).
  • Macrolides probably decrease severe exacerbations (requiring ED visits or systemic steroids) (moderate-certainty evidence).
  • Evidence suggests potential symptom reduction and slight improvement in Asthma Control Questionnaire (ACQ) scores, but with very low to low certainty.

Conclusions:

  • Macrolides show a probable benefit in reducing asthma exacerbation rates, particularly severe events.
  • The overall certainty of evidence is low to very low due to heterogeneity and potential biases, limiting definitive conclusions.
  • Further high-quality research is needed to confirm macrolide efficacy across asthma phenotypes and compare them with newer treatments.