Asthma clinical evaluation

Given the routine use of mast cell stabilizers in the clinic, for example in the setting of asthma treatment, these preclinical results may stimulate clinical evaluation in humans. 

The initial publication was sharply criticized by other workers [360] who had reached diametrically opposed conclusions from their own studies and these, in turn, were examined and points of difference clarified by the original authors [361 ]. This exchange reveals the clinical evaluation of a new aid to asthma therapy a too complex for easy resolution of differences of approach and view. 

Upadhyaya SD, Kansal CM, Pandey NN. Clinical evaluation of Piper longum on patients of bronchial asthma—a preliminary study. Nagarjuna 1982 25 256- 258. 

The goal of this case study was, using an in silico approach with the Entelos Asthma PhysioLab Platform, to evaluate the potential of PDE4 as a drug target for moderate asthma, by evaluating the clinical impact of PDE4 inhibition in moderate asthmatic patients. 

Pftortn. Suec. 24 333 (1987). LC determn. O. Wannerberg, B- Persson, J. Chromatog. 435, 199 (1988X Clinical evaluation in asthma T. Sandstrom et ol, Respiration 53, 31... 

A patient with a history of episodic attacks of coughing, wheezing, and shortness of breath is being evaluated in the asthma clinic. Several drug treatments with different routes of administration are under consideration. Which of the following statements about routes of administration is MOST correct ... 

Double Blind Single Crossover Clinical Evaluation of Disodium Cromoglycate in Bronchial Asthma. 

Airway hyperresponsiveness is defined as the exaggerated ability of the airways to narrow in response to a variety of stimuli. Although AHR exists in patients without asthma, it is a characteristic feature of asthma and appears to be directly related to airway inflammation and the severity of asthma.1,3 Treatment of airway inflammation with inhaled corticosteroids attenuates AHR in asthma but does not eliminate it.1 Clinically, AHR manifests as increased variability of airway function. Although not commonly used to diagnose asthma, AHR can be evaluated clinically using a methacholine or histamine bronchoprovocation test. 

Of course, it is not always necessary to rely on biomarkers for rapid evaluation of dose-response relationships in ED. Thus, efficacy of new drugs is readily demonstrated in terms of the clinical endpoint for diseases, such as migraine, inflammatory pain, asthma, psoriasis, glaucoma and many others. 

It is important to include all age ranges that are of clinical importance. Development of an anti-asthma drug, for example, should include a programme of evaluation in children as well as adults because they will form a significant portion of the database and risk-benefit considerations will be different. Development of an anti-arthritis compound, on the other hand, will be undertaken predominantly in older patients and particularly detailed information on efficacy and safety in the elderly will be required. 

From a clinical perspective, some of these PCO classes have attracted initial attention. Diazoxide and minoxidil have been evaluated as antihypertensive agents. These PCOs open K+ channels in the plasma membranes of vascular smooth muscle cells, causing vascular vasodilation, thereby lowering blood pressure. Cromakalim has been investigated as a smooth muscle bronchodilator for the treatment of human asthma. Nicorandil was launched in Japan in 1984 for the treatment of angina because of its perceived ability to promote vasodilation of coronary arteries. Developmental work on these and other PCOs is continuing for indications ranging from hypertension, asthma, urinary incontinence, psychosis, epilepsy, pain, and alopecia (hair loss). 

There have been limited field and controlled exposure studies that evaluated human reactions to carpet emissions. Winfield (1987) described a USA primary school where odor, headache, nausea, fatigue and mucosal irritation were reported by a high proportion of the students. Elevated indoor air concentrations of styrene (900-4000 xg m 3) were found, which were believed to be due to a SB R latex-backed carpet which had been installed several years previously. The carpet was removed and the ill-effects were reported to abate. Johnsen et al. (1990) exposed asthma sufferers to a foam rubber-backed carpet in a room chamber. While no clinical effects on lung function were observed, objective eye measurements found that there was a change in tear film quality. This was proposed to result from a degreasing effect of lipophilic VOCs, identified as toluene and acetone (Wolkoff, Nielsen and Hansen, 1990). 

Prior to oral food challenges, patients should avoid the suspected food(s) for at least two weeks and discontinue antihistamines or long-term asthma medications (beta-agonists) according to their elimination half-life. They should be evaluated carefully, before the challenge, for the presence of any clinical symptoms (The Food Allergy and Anaphylaxis Network, 2005 Chapman et al 2006). 

In a randomized, double-blind, placebo-controUed, multicenter evaluation of the clinical efficacy and safety of salmeterol 42 micrograms bd in 538 asthmatic patients, mean peak flow rate improved significantly in the patients who used salmeterol (2). The use of supplementary salbutamol, asthma symptom scores, and FEVi were... 

Double-blind controlled trials have failed to demonstrate an unequivocal link between exposure to MSG and CRS because many of the individuals who had a history of suffering from symptoms after ingestion of MSG also reacted positively to the placebo. Furthermore, upon second challenge, the symptoms were different than what they had experienced previously. Therefore, there are cases of individuals who are sensitive to MSG. However, the response is difficult to evaluate clinically. It has been suggested that MSG can trigger an asthma attack in sensitive individuals suffering from severe unstable asthma. However, the studies investigating this link have been inconclusive. 

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