Leukotriene modulators

Mild persistent > twice a week but < once a day Exacerbations may affect activity >80% predicted PEF variability 20-30% Step 1 and ONE of the following Antiinflammatory therapy (low dose of inhaled corticosteroid) Cromolyn or nedocromil Theophylline Leukotriene modulator... 

Leukotriene modulators Nedocromil Sodium Tilade Inhalation... 

C) Status asthmaticus is best treated with inhaled controller medication, such as cromolyn sodium or a leukotriene modulator. 

B. Status asthmaticus is a dangerous exacerbation of asthma symptoms. It requires immediate and aggressive treatment with oxygen, inhaled bronchodilators, and systemic corticosteroids. Hospitalization of the patient is often indicated. By definition, status asthmaticus is not a condition in which symptoms are well controlled. Neither cromolyn sodium nor a leukotriene modulator is indicated for the treatment of status asthmaticus, as their onset of action is too slow. Status asthmaticus often does not resolve without aggressive intervention. Indeed, the patient s condition can deteriorate rapidly to death. Upper respiratory tract infection or excessive exposure to an allergen often precedes status asthmaticus, as does increased use of inhaled bronchodilators. 

In this review, we first describe the paths and enzymes leading to prostaglandins, leukotrienes, and lipoxins. We then take each of our topics, separately dealing with leukotriene modulators followed by cyclooxygenase inhib-... 

Zafirlukast formulated as Accolate was the first leukotriene modulator approved in the United States. This compound has also been extensively reviewed (256-258). Given 40 mg bid it has been shown to be clinically effective in the treatment of asthma. 

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