Treatment bronchial disease

Neutrophil elastase is implicated in the induction of bronchial disease, causing structural changes in lungs, impairment of mucociliary clearance, and impairment of host defenses. Protease inhibitors, namely, inhibitors of neutrophil elastase, are being investigated currently for the treatment of COPD. 

Medici TC, Shang H, Grosgurin P et al (1985) No demonstrable effect of sobrerol as an expectorant in patients with stable chronic bronchial diseases. Bull Exp Physiopathol Respir 21 477-83 Melchart D, Linde K, Fischer P et al (1999) Echinacea for preventing and treating the common cold, Cochrane Database Syst Rev Issue 1, Art No, CD000530 Melchior J, Spasov AA, Ostrovskij OV et al (2000) Double-blind, placebo-controlled pilot and phase 111 study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan Jang) in the treatment of uncomplicated upper respiratory tract infection. Phytomedicine 7 341-350... 

Therapeutic aerosols play a prominent role in the treatment of diseases of the lower airways, such as bronchial asthma and chronic bronchitis. It has been proposed that an increased deposition in the peripheral airways would be of value, in particular for treatment with inhaled corticosteroids. In patients with asthma, tracheobronchial deposition could be increased, practically independent of airway dimensions, by inhaling large aerosol particles extremely slowly (17,114). This could be a potentially useful approach of therapeutic importance, particularly in the treatment of patients with airways obstruction. Still, another possibility to enhance deposition of therapeutic aerosols in asthmatics could be the use of carrier gases such as helium-oxygen mixture (113). 

There are a wide variety of approaches to the use of gene therapy in the treatment of disease. Firstly, gene transfer can take place either ex vivo or in vivo. In the ex vivo technique the patient s cells are harvested, treated, genetically modified and re-administered to the patient. In the in vivo approach, a gene, normal or modified, is introduced directly into the body or in one specifically targeted organ of the patient such as muscle, bronchial epithelium or cancer tumour cells . 

The answer is c. (Hardman, pp 156-158.) A wide variety of clinical conditions are treated with antimuscarinic drugs. Dicyclomine hydrochloride and methscopolamine bromide are used to reduce Gl motility, although side effects—dryness of the mouth, loss of visual accommodation, and difficulty in urination—may limit their acceptance by patients. Cyclopentolate hydrochloride is used in ophthalmology for its mydriatic and cycloplegic properties during refraction of the eye. Trihexyphenidyl hydrochloride is one of the important antimuscarinic compounds used in the treatment of parkinsonism. For bronchodilation in patients with bronchial asthma and other bronchospastic diseases, ipratropium bromide is used by inhalation. Systemic adverse reactions are low because the actions are largely confined to the mouth and airways. 

Theophylline reduces contractile activity of smooth musculature, widens bronchi and blood vessels, reduces pulmonary vascular resistance, stimulates the respiratory center, and increases the frequency and power of cardiac contractions. It is used for bronchial asthma, preventing attacks, and systematic treatment. Theophylline is also used for symptomatic treatment of bronchospastic syndrome of a different etiology (chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary emphysema). A large number of combined drags are based on theophylline. Synonyms of theophylline are adophyllin, asthmophyllin, theocin, and many others. 

Propranolol, nadolol, timolol, penbutolol, carteolol, sotalol, and pindolol Bronchial asthma or bronchospasm, including severe chronic obstructive pulmonary disease. Metoprolol Treatment of Ml in patients with a heart rate less than 45 beats/min significant heart block greater than first degree (PR interval 0.24 seconds or more) systolic blood pressure less than 100 mm Hg moderate to severe cardiac failure. Sotalol Congenital or acquired long QT syndromes. 

IR concentrated oral solution and tablets/suppositories - Respiratory insufficiency or depression severe CNS depression attack of bronchial asthma heart failure secondary to chronic lung disease cardiac arrhythmias increased intracranial or CSF pressure head injuries brain tumor acute alcoholism delirium tremens convulsive disorders after biliary tract surgery suspected surgical abdomen surgical anastomosis concomitantly with MAOIs or within 14 days of such treatment paralytic ileus. 

It is a cyclic polypeptide with 11 amino acids. It selectively inhibits T-lymphocytes proliferation, IL-2 and other cytokine production. It is the most effective drug for prevention and treatment of graft rejection reaction. It is used in cardiac, hepatic, renal, bone marrow transplantation and as second line drug in rheumatoid arthritis, inflammatory bowel disease, dermato-myositis, bronchial asthma and certain other autoimmune diseases. 

Bronchodilation. p2-Adrenoceptor-medi-ated bronchodilation plays an essential part in the treatment of bronchial asthma and chronic obstructive lung disease (p.340). For this purpose, p2-agonists are usually given by inhalation preferred agents being those with low oral bioavailability and low risk of systemic unwanted effects (e. g., feno-terol, salbutamol, terbutaline). 

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