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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Drugs Used in Lower Respiratory Disorders: Overview01:17

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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
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Inflammatory Bowel Disease IV: Pharmacological Management01:29

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
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Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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Upper respiratory tract disorders, including viral infections and allergic rhinitis, cause significant discomfort and disrupt daily life. Managing these conditions involves a variety of drugs, such as antihistamines, intranasal steroids, decongestants, antitussives, expectorants, and mucolytics. Specific examples of drugs in each category are provided.
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Drugs for paediatric hyperinflammatory syndromes.

Kam Lun Hon1, Alexander Kc Leung2, Wing Hang Leung3

  • 1Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong.

Drugs in Context
|June 20, 2022
PubMed
Summary
This summary is machine-generated.

Hyperinflammatory syndromes in children present with vague symptoms, challenging diagnosis. This review covers pathophysiology, manifestations, and management of these conditions, including multisystem inflammatory syndrome in children (MIS-C).

Keywords:
COVID-19cytokine release syndromecytokine storm syndromehaemophagocytic lymphohistiocytosishyperinflammatory syndromesmacrophage activation syndromemultisystem inflammatory syndrome in children

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Area of Science:

  • Pediatric critical care medicine
  • Immunology
  • Infectious diseases

Background:

  • Hyperinflammation in children often presents with non-specific symptoms, complicating diagnosis and management.
  • Recent literature overemphasizes multisystem inflammatory syndrome in children (MIS-C) related to COVID-19, neglecting other hyperinflammatory syndromes.
  • Understanding diverse hyperinflammatory syndromes is crucial for effective pediatric care.

Purpose of the Study:

  • To provide an updated narrative review on hyperinflammatory syndromes in children.
  • To detail the pathophysiology, clinical manifestations, and management strategies.
  • To differentiate hyperinflammatory syndromes from other inflammatory conditions.

Main Methods:

  • Extensive PubMed search using keywords like "hyperinflammation" and "hyperinflammatory syndromes".
  • Focused on English literature, reviews, and clinical trials for pediatric age groups (birth to 18 years).
  • Utilized Clinical Queries for targeted search refinement.

Main Results:

  • Hyperinflammatory syndromes encompass conditions with multisystem involvement and aberrant cytokine release.
  • Key subtypes include macrophage activation syndrome, hemophagocytic lymphohistiocytosis, cytokine release syndrome, and cytokine storm syndrome.
  • Multisystem inflammatory syndrome in children (MIS-C) is a recent addition, associated with SARS-CoV-2 but also other viral infections.

Conclusions:

  • Early recognition and prompt treatment are vital for improving outcomes and survival rates in pediatric patients.
  • While corticosteroids are initial treatments, disease-specific drugs and biologics are often necessary.
  • Expert management is crucial due to the complexity and high mortality associated with most hyperinflammatory syndromes, excluding MIS-C.