treatment of asthma  
 
 
 

 

     

Treatment of asthma

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Methylxanthines

Theophylline, the methylxanthine principally used in treating asthma, provides mild-to-moderate bronchodilation. Monitoring serum theophylline concentrations is essential to ensure that therapeutic, but not toxic, doses are achieved. 
Recent evidence suggests that low serum concentrations of theophylline are mildly anti-inflammatory.
Sustained-release theophylline is mainly used as adjuvant therapy, and is particularly useful for controlling symptoms of nocturnal asthma. 
When there are issues concerning cost or adherence to regimens using inhaled medication, sustained-release theophylline can be considered as an alternative long-term preventive therapy, but is not preferred. 

Note: Patients on chronic theophylline should have a serum theophylline determination at least once each year to decrease the risk of theophylline toxicity. Elderly asthmatics should also be monitored closely as they may be suffering from other illness like heart disease.

Leukotriene Modifiers

Leukotriene modifiers can be considered an alternative therapy to low doses of inhaled steroids or cromolyn or nedocromil for patients 12 years of age (childhood asthma) or older with mild persistent asthma. 
According to the 1998 Leukotriene Working Group, leukotriene pathway modifiers may be useful as first-line therapy for mild persistent asthma or as an add-on or glucocorticoid-sparing medication in others. These agents are less effective than glucocorticoid inhalers but tend to improve compliance because of once-a-day oral dosing. 

Anticholinergics

Ipratropiium bromide may be an alternative bronchodilator for some patients who do not tolerate inhaled beta2-agonists. It may also provide some additive benefit to inhaled beta2-agonists during severe exacerbations 

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   Contents of page- 3
 Methylxanthines
 Leukotriene Modifiers
 Anticholinergics
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Last edited 24-11-2009