Chronic persistent asthma: A review of medicines in the step-up approach

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dc.contributor.authorIrusen E.M.
dc.date.accessioned2011-05-15T16:17:57Z
dc.date.available2011-05-15T16:17:57Z
dc.date.issued2008
dc.description.abstractThe medications used in asthma have been the subject of intense study over the last three decades. We now have extensive insights into their structure, regulation, receptors and mechanisms of action. Their intersection with the complexity of asthma inflammation has also been well characterised. In parallel, good quality pharmaceutical trials have informed national guidelines and patient-centered outcomes have been explored. With this therapeutic armamentarium the practitioner should aim to achieve the goals of asthma therapy that are focused on clinical and lung function parameters. The concept of complete asthma control is the current benchmark. Airway inflammation is the fundamental problem in asthma and, logically, anti-inflammatory therapy in the form of inhaled corticosteroids is the single most important intervention. The importance of appropriate use of inhaler devices cannot be sufficiently emphasised. The clinician carefully titrates this treatment utilising additional medications for synergy and to modulate side-effects and costs. The contemporary standard of asthma care is a single inhaler with a combination of inhaled corticosteroids (ICS) and long-acting beta adrenoceptor agonists. The alternative is to add leukotriene modifiers to ICS therapy; there are special circumstances when this may be more appropriate. Poor inhaler use and concomitant allergic rhinitis are examples when supplementation with anti-leukotriene agents would be prudent. With whatever therapeutic strategy, regular education of the patient, tailoring of medication and monitoring of asthma are still crucial to ensure that the goals of asthma control are achieved and maintained in the long term.
dc.description.versionReview
dc.identifier.citationSouth African Family Practice
dc.identifier.citation50
dc.identifier.citation4
dc.identifier.issn1726426X
dc.identifier.urihttp://hdl.handle.net/10019.1/14444
dc.subjectbeclometasone dipropionate
dc.subjectbeta 2 adrenergic receptor stimulating agent
dc.subjectbeta adrenergic receptor stimulating agent
dc.subjectbronchodilating agent
dc.subjectbudesonide
dc.subjectbudesonide plus formoterol
dc.subjectcholinergic receptor blocking agent
dc.subjectciclesonide
dc.subjectcimetidine
dc.subjectcorticosteroid
dc.subjectcromoglycate disodium
dc.subjectfluticasone propionate
dc.subjectfluticasone propionate plus salmeterol
dc.subjectleukotriene receptor affecting agent
dc.subjectleukotriene receptor blocking agent
dc.subjectmacrolide
dc.subjectmontelukast
dc.subjectnedocromil sodium
dc.subjectquinoline derivative
dc.subjectsalbutamol
dc.subjectsalmeterol
dc.subjecttheophylline
dc.subjectzafirlukast
dc.subjectadd on therapy
dc.subjectallergic rhinitis
dc.subjectantiinflammatory activity
dc.subjectasthma
dc.subjectcandidiasis
dc.subjectcataract
dc.subjectclinical trial
dc.subjectcomorbidity
dc.subjectCushingoid syndrome
dc.subjectdrug antagonism
dc.subjectdrug dose increase
dc.subjectdrug dose reduction
dc.subjectdrug dose sequence
dc.subjectdrug efficacy
dc.subjectdrug mechanism
dc.subjectdrug metabolism
dc.subjectdrug receptor binding
dc.subjectdrug safety
dc.subjectexercise induced asthma
dc.subjectgastrointestinal disease
dc.subjectgrowth disorder
dc.subjectheart disease
dc.subjecthuman
dc.subjectlarynx disorder
dc.subjectlow drug dose
dc.subjectneurologic disease
dc.subjectpatient compliance
dc.subjectpatient education
dc.subjectpeak expiratory flow
dc.subjectpharyngeal candidiasis
dc.subjectreceptor affinity
dc.subjectrespiratory tract inflammation
dc.subjectreview
dc.subjectskin bruising
dc.titleChronic persistent asthma: A review of medicines in the step-up approach
dc.typeReview
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