jiří slíva m.d. absolute number of patients suffering from ab in czech. rep. period number of...
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Jiří Slíva M.D.
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Absolute number of patients suffering from AB in Czech. Rep.
Period
Number of patients
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THE MOST IMPORTANTALERGENES
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JANUARY
FEBRUARY
MARCH
APRIL
MAY
1. DEC. 2. DEC. 3. DEC. Pollen situation of„Alnusglutinosa“ in the Europe
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DIAGNOSIS
1. ANAMNESIS
3. LABORATORYTESTS
2. CLINICALFEATURES
4. ALLERGOLOGICAL TESTS
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own pharmacoterapylife style
specific imunotherapy
symptomaticantiinflammatoric
preventive
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• sympatomimetics
• anticholinergics
• corticosteroides
• methylxantines
• antileucotriens
• antihistamines
Groups of drugs:
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β-mimetics
- nonselective - adrenaline, isoproterenol, orciprenaline, ephedrine
- selective - metaproterenol, albuterol, salbutamol, terbutalin, fenoterol => more effective via inhalation then per os administration => increase of cAMP
Parasympatolytics
ipratropium
Antiasthmatics with rapid effect:
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theophylline - myotropic influence via inhibition of phosphodiesterase and via influence on the adenosine receptors A2
=> bronchodilatation
=> prevention from bronchoconstriction caused by histamine, cholinergic agonists (metacholine) or exertion.
Aminophylline = theophylline + ethylendiamine
Methylxantines:
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inhibition of degranulation of mastocytes after exposition to specific agents full effect after 4-6 weeks
Drugs used for prevention and maintained treatment:
cromoglycate sodium
nedocromil• similar to cromoglycate in mechanism of action
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β2-mimetics with long-term effect:
• via inhalation salmeterol and formoterol • via per os ( tabl, sirup) klenbuterol, prokaterol, salbutamol
Teophylline with prolonged releasing
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zafirlukast zileuton montelukast
Antileucotriens =
Leucotriene Receptor Antagonists (LTRAs):
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beklometasone budesonide flunisolide fluticasone triamcinolone
potent antiinflammatory effect
decrease of number of inflammatory potent
cells
inhibition of bronchoconstrictory mechanisms
direct relaxation of smooth muscle cells
Corticosteroids:
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astemizole (Hismanal) clemastineterphenadineketotifen (Zaditen)
reversible competitive antagonists of H-receptors
Antihistamines:
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verapamile (Isoptin) nifedipine others
inhibition of calcium influx => inhibition of contraction of smooth muscle cells
induction of bronchodilatation
used experimentaly
Inhibitors of calcium channels:
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Comparison of numbers of drugs used in therapy of bronchial asthma