Airway diseases, treatment

Treatment or prevention of bronchospasm in adults and adolescents 12 years and older with reversible obstructive airway disease... 

Zanamivir is not recommended for treatment of patients with underlying airways disease such as asthma or chronic obstructive pulmonary disease (CORD) (see Warnings). 

Underlying respiratory disease Zanamivir has not been shown to be effective and may carry risk in patients with severe or decompensated COPD or asthma, and serious adverse events have been reported in such patients. Therefore, zanamivir is not generally recommended for treatment of patients with underlying airways disease such as asthma or COPD. 

Erdosteine is recently introduced mucolytic with unique protective functions for the respiratory tract. It is indicated in the treatment of acute and chronic airway diseases such as bronchitis, rhinitis, sinusitis, laryngopharyngitis and exacerbations of chronic bronchitis. 

Barnes J Novel signal transduction modulators for the treatment of airway diseases. Pharmacol Ther 2006 109 238. [PMID 16171872]... 

A number of muscarinic agonists and antagonists are launched or in clinical trials, especially as antiemetics (e.g. scopolamine), as treatment for urinary incontinence (e.g. tolterodine), glaucoma (pilocarpine), and airway diseases (e.g. ipratropium bromide), but, to the best of our knowledge, only few are used as adjuvants in analgesic compositions, e.g. tiemonium iodide which is used in various combinations with analgesics like paracetamol or metamizole (Coffalon , Visceralgine ). 

It is recommended to propose a strategy combining the treatment of both the upper and lower airway disease in terms of efficacy and safety. 

In conclusion, the ARIA WHO workgroup emphasized the link between rhinitis and asthma and declared rhinitis a major chronic respiratory disease and a risk factor for the development of lower airway disease. It is therefore critical to treat both airway manifestations in a combined strategy, and immunotherapy has been proven to be a suitable treatment when patients are selected carefully. 

It must be our aim to prevent the development of asthma in patients, especially in children with rhinitis, and SIT has been shown to considerably reduce the risk of disease expansion in this group of patients that otherwise would develop asthma in about 35-45% of cases. SIT clearly is a treatment of choice for common airway disease such as a reductive and preventive treatment approach. Further studies are needed to confirm this benefit and to allow a better classification of patients suitable for preventive SIT in terms of sensitizations, age and laboratory parameters. 

Neuraminidase is an essential viral glycoprotein for virus replication and release. The neuraminidase inhibitors zanamivir and oseltamivir have recently been approved for the treatment of acute uncomplicated influenza infection. When a 5-day course of therapy is initiated within 36-48 hours after the onset of symptoms, use of either agent shortens the severity and duration of illness and may decrease the incidence of respiratory complications in children and adults. Unlike amantadine and rimantidine, zanamivir and oseltamivir have activity against both influenza A and influenza B. Zanamivir is administered via oral inhaler. The compound displays poor oral bioavailability, limited plasma protein binding, rapid renal clearance, and absence of significant metabolism. Nasal and throat discomfort may occur—as well as bronchospasm in patients with reactive airway disease. 

Flynn RA, Glynn DA, Kennedy MP (2009) Anticholinergic treatment in airways diseases. Adv Ther 26 908-919... 

Filair 100 Inhaler is indicated for the prophylactic treatment of chronic reversible obstructive airways disease (also budesonide, fluticasone - unlicensed, though Seretide Accuhaler is licensed). 

In the fields of allergy and respiration, examples include 2-oxo-3-aminoazepine derivatives which act as dual neurokinin (tachykinin) NK1/NK2 receptor probes for development of options for treatment of asthsma and other airway diseases <07BMCL890> and benzo[l, 5]diazepine derivatives as new non-steroidal inhibitors of 17-P-hydroxysteroid dehydrogenase, an enzyme associated with hormone-dependent and neuronal diseases <07JEIMC29>. 

The Respimat inhaler was recently launched in Germany as a combination product of fenoterol and ipratropium hydrobromide (Berodual) and was licensed for the treatment of chronic obstructive airway disease. A large body of literature now exists documenting the aerosol characteristics and clinical performance of the Respimat inhaler with a number of different drugs [274,275]. Aerosolized formulations include the steroids budesonide and flunisolide in addition to the p agonist fenoterol as well as the commercially available combination product of fenoterol and ipratropium bromide [276-281],... 

Respiratory Disorders. Topically applied P-blockers can induce asthma or dyspnea in patients with preexisting chronic obstructive pulmonary disease. Clinicians should inquire about a history of pulmonary disorders before initiating glaucoma treatment with P-blockers. A history of restrictive airway disease also contraindicates the use of opioids for treatment of ocular pain. 

Gonzalez JP, Brogden RN. NedocromU sodium a preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic efficacy in the treatment of reversible obstructive airway disease. Drugs 1987 34 560-567. 

In a blind, randomized study, 29 children aged under 2 years, with moderate to severe acute exacerbations of hyper-reactive airways disease, were treated with either a standard dose of nebulized salbutamol (0.15 mg/kg) or a low dose of nebulized salbutamol (0.075 mg/kg) plus nebulized ipratropium bromide 250 micrograms (4). Standard and low-dose nebulized salbutamol was given three times at intervals of 20 minutes and nebulized ipratropium bromide was given once. Clinical improvement, measured as O2 saturation and relief of respiratory distress, was similar in both groups. QT dispersion was measured at baseline and after treatment and was... 

Lai S, Dorow PD, Venho KK, Chatterjee SS. Nedocromil sodium is more effective than cromolyn sodium for the treatment of chronic reversible obstructive airway disease. Chest 1993 104(2) 438 7. 

Mast cell stabilizers are indicated for the treatment of inflammatory airway disease in some horses. Inflammatory airway disease is observed in yoimg horses the clinical syndrome is characterized by poor exercise performance, chronic cough and the presence of exudate in the tracheobronchial tree. A subset of horses with inflammatory airway disease will have metachromatic inflammation in bronchoalveolar lavage, with mast cells constituting 2-5% of the total cell count. This form of chronic lower airway inflammation probably represents a local pulmonary hypersensitivity reaction. There is controversy as to whether this form of inflammatory airway disease represents an early form of recurrent airway obstruction. Nebulization of sodium cromoglicate (200 mg) will improve the clinical signs of respiratory disease and will stabilize mast cell histamine release (Hare et al 1994). 

Selective 182-adrenergic receptor agonists (ft agonists) are widely used in the treatment of airway diseases such as asthma because of their bronchodilating action. In addition, ft agonists have anti-inflammatory effects, in that they can inhibit the release of inflammatory mediators and can decrease plasma leakage (Svensjo et al., 1977 Tomioka etal., 1981 Erjefalt and Persson, 1986 Barnes,... 

Busse, W.W. and Gaddy, J.N. (1991). The role of leukotriene antagonists and inhibitors in the treatment of airway disease. Am. Rev. Respir. Dis. 143, S103-S107. 

BRONCHODILATOR and ANTIASTHMATIC properties. It can also be used in conjunction with guaifenesin in the treatment of obstructive airways disease. 

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