Montelukast toxicity

Of these agents, zileuton is the least prescribed because of reports of occasional liver toxicity. The receptor antagonists appear to have little toxicity. Reports of Churg-Strauss syndrome (a systemic vasculitis accompanied by worsening asthma, pulmonary infiltrates, and eosinophilia) appear to have been coincidental, with the syndrome unmasked by the reduction in prednisone dosage made possible by the addition of zafirlukast or montelukast. Of these two, montelukast is the most prescribed, probably because it can be taken without regard to meals and because of the convenience of once-daily treatment. 

Treatment with a leukotriene-receptor antagonist, particularly montelukast, is widely prescribed, especially by primary care providers. Taken orally, leukotriene-receptor antagonists are easy to use and appear to be used more regularly than inhaled corticosteroids. They are rarely associated with troublesome side effects. Maintenance therapy with a leukotriene antagonist or with cromolyn or nedocromil appears to be roughly as effective as maintenance therapy with theophylline. Because of concerns over the possible long-term toxicity of systemic absorption of inhaled corticosteroids, this maintenance therapy is widely used for treating children in the USA. 

Montelukast, zafirlukast Block leukotriene D4 receptors Block airway response to exercise and antigen challenge Prophylaxis of asthma, especially in children and in aspirin-induced asthma Oral duration hours Toxicity Minimal... 

This class of drugs is not indicated for rapid bronchodilator therapy thus, patients are instructed to have short-acting f adrenergic receptor agonists available as rescue medication. Montelukast and zafirlukast are effective with once- or twice-daily treatment, respectively. In contrast, zileuton is taken 4 times a day. Hepatic transaminases should be monitored in patients beginning zileuton therapy to guard against the potential of liver toxicity. 

Montelukast 7 is an orally active selective leukotriene receptor antagonist used for the treatment of asthma. With an annual volume of approximately 20 metric tons per year and a synthetic route that requires both large amount of solvents and a toxic, difficult-to-handle chiral reducing agent, montelukast represented an attractive target for biocatalysis as a way to implement a greener, more efficient process. 

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