Asthma bronchial

Aminophylline (theophylline ethylenediamine), given intravenously, is used in patients with status asthmaticus who do not respond to epinephrine. In addition, epinephrine may be administered subcutaneously for acute asthma attacks. Epinephrine may also be given along with theophylline. It is thought that the bronchodilation is associated with me enhanced concentration of cyclic AMP, which is metabolized according to the following sequence  

Epinephrine stimulates me beta-adrenergic receptors in me bronchioles, which in turn activate membrane-bound adenylate cyclase to synthesize more cyclic AMP, whereas theophylline inhibits the activity of phosphodiesterase, conserving the previously synthesized cyclic AMP. 

Definition. A recurrent, episodic shortness of breath caused by bronchoconstriction arising from airway inflammation and hyperreactivity. 

The step scheme (B) illustrates successive levels of pharmacotherapeutic management at increasing degrees of disease severity. 

Step 1. Medications of first choice for the acute attack are short-acting, aerosolized fS2-sympathomimetics, e.g., salbutamol or feno-terol. Their action occurs within minutes after inhalation and lasts for 4-6 hours. 

Step 2. If p2-mimetics have to be used more frequently than once a week, more severe disease is present. At this stage, management includes anti-inflammatory drugs, preferably an inhalable glucocorticoid 

Anti-inflammatory therapy is the more successful the less use is made of as-needed p2-mimetic medication. 

Useful for improved bio-availability from gastrointestinal tract. 210 

The membrane could be employed as an artificial insulin distributor. 211 

Membrane can be used as substrate for culturing islets of Langerhans for a bioartificial insulin distributor. 212 

Useful in treating diseases in the CNS- related to the metabotropic glutamate receptor system. 214 

M = (Un) Substd. heterocyclic atom grouping Q = Unsubstd. Cycloalkyl T = H R = (Un) substd. aminoalkyl] 

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Nacconate 100 A lachrymatory liquid b.p. 25l°C. Manufactured from phosgene and 2,4-diaminotoJuene. Used for preparing polyurethane foams and other elastomers by reaction with polyhydroxy compounds. Produces skin irritation and causes allergic eczema and bronchial asthma. 

Although the mechanism of glucocorticosteriod action in bronchial asthma is not fully understood, various possibiUties have been discussed in... 

Acetyl-P-methylcholine chloride [62-51-1/, commonly called methacholine chloride, is a parasympathornimetic bronchoconstrictor with clinical efficacy in bronchial asthma (45,46). 

Saussurea Cappa Clarke. The root contains saussurine i which, according to Prasad, accounts for the effect of the drug in controlling attacks of bronchial asthma, especially of the vagotonic type. ((1) Ghosh, Chatterjee and Dutta, J. Ind. Chem. Soc., 1929, 6, 517 (2) Ind. J. Pharm., 1945, 7, 81.)... 

How might a reductive animation be used to synthesize ephediine, an amino alcohol that is widely used for the treatment of bronchial asthma ... 

Leukotrienes are rapidly produced and released during a Type I reaction (Fig. 3). They are responsible for a massive bronchoconstriction in allergic bronchial asthma and attract leukocytes, thus being proinflamma-tory. Consequently, antagonists of the LTC recqDtor have been proven useful in the therapy of bronchial asthma, often in combination with bronchodilators (example montelukast). 

This includes bronchial asthma, autoimmune, and chronic inflammatory diseases. 

Bronchial Asthma. Figure 2 Mechanisms of bronchial hyperresponsiveness. Toxic products from eosinophils [cationic peptides, reactive oxygen species (ROS)] cause epithelial injury. Nerve endings become easily accessible to mediators from mast cells, eosinophils [eosinophil-derived neurotoxin (EDN)], and neutrophils, and to airborne toxicants such as S02. Activation of nerve endings stimulates effector cells like mucosal glands and airway smooth muscle either directly or by cholinergic reflexes. 

Bronchial Asthma. Table 1 Asthma therapy, according to the German guidelines for asthma and the GINA report 2006 (GINA, http //www.ginasthma.org). FEV1, forced expiratory volume in 1 s... 

Glucocorticoids Immunosuppressive Agents Bronchial Asthma Allergy... 

Inhaled NO has been used for treatment of persistent pulmonary hypertension of newborn infants, critical respiratory failure of preterm infants, and acute hypertension of adult cardiac surgery patients. PDE-5 inhibitors such as sildenafil are also effective for treatment of pulmonary hypertension. The combination of PDE-5 and NO inhalation yields additive beneficial effects on pulmonary hemodynamics. On the other hand, measurement of exhaled NO is a noninvasive and reproducible test that is a surrogate measure of airway inflammation in patients with bronchial asthma. 

The sulfonamides are used with caution in patients with renal or hepatic impairment and bronchial asthma. These drugs are given with caution to patients with allergies. Safety for use during pregnancy has not been established (Pregnancy Category C, except at term). 

Injection shock, bronchospasm during anesthesia, cardiac standstill and arrhythmias Inhalation acute bronchial asthma, emphysema, bronchitis, bronchiectasis... 

Both carvedilol and labetalol are contraindicated in patients with hypersensitivity to the drag, bronchial asthma, decompensated heart failure, and severe bradycardia The drugs are used cautiously in patients with drag-controlled congestive heart failure, chronic bronchitis, impaired hepatic or cardiac function, in those with diabetes, and during pregnancy (Category C) and lactation. 

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