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Asthma bronchiale

Asthma bronchiale. Jiří Slíva M.D. Absolute number of patients suffering from AB in Czech. Rep. Number of patients. Period. THE MOST IMPORTANT ALERGENES. Pollen situation of„Alnus glutinosa“ in the Europe. 1. DEC. 2. DEC. 3. DEC. JANUARY FEBRUARY MARCH APRIL MAY. DIAGNOSIS.

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Asthma bronchiale

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  1. Asthma bronchiale Jiří Slíva M.D.

  2. Absolute number of patients suffering from AB in Czech. Rep. Number of patients Period

  3. THE MOST IMPORTANT ALERGENES

  4. Pollen situation of„Alnus glutinosa“ in the Europe 1. DEC. 2. DEC. 3. DEC. JANUARY FEBRUARY MARCH APRIL MAY

  5. DIAGNOSIS 2. CLINICAL FEATURES 1. ANAMNESIS 4. ALLERGOLOGICAL TESTS 3. LABORATORY TESTS

  6. THERAPY life style own pharmacoterapy specific imunotherapy preventive antiinflammatoric symptomatic

  7. Groups of drugs: • sympatomimetics • anticholinergics • corticosteroides • methylxantines • antileucotriens • antihistamines

  8. Antiasthmatics with rapid effect: • β-mimetics • - nonselective - adrenaline, isoproterenol, orciprenaline, ephedrine • - selective -metaproterenol, albuterol, salbutamol, • terbutalin, fenoterol • => more effective via inhalation then per os administration • =>increase of cAMP • Parasympatolytics • ipratropium

  9. Methylxantines: • theophylline - myotropic influence via inhibition of phosphodiesterase and via influence on the adenosine receptors A2 • =>bronchodilatation • => prevention from bronchoconstriction caused by histamine, cholinergic agonists (metacholine) or exertion. • Aminophylline = theophylline + ethylendiamine

  10. Drugs used for prevention and maintained treatment: cromoglycate sodium • inhibition of degranulation of mastocytes after exposition to specific agents • full effect after 4-6 weeks • nedocromil • similar to cromoglycate in mechanism • of action

  11. β2-mimetics with long-term effect: • via inhalation salmeteroland formoterol • via per os ( tabl, sirup)klenbuterol, prokaterol, salbutamol Teophylline with prolonged releasing

  12. Antileucotriens = Leucotriene Receptor Antagonists (LTRAs): • zafirlukast • zileuton • montelukast

  13. Corticosteroids: • beklometasone • budesonide • flunisolide • fluticasone • triamcinolone • potent antiinflammatory effect • decrease of number of inflammatory potent cells • inhibition of bronchoconstrictory mechanisms • direct relaxation of smooth muscle cells

  14. Antihistamines: • astemizole(Hismanal) • clemastine • terphenadine • ketotifen (Zaditen) • reversible competitive antagonists of H-receptors

  15. Inhibitors of calcium channels: • verapamile (Isoptin) • nifedipine • others • inhibition of calcium influx => inhibition of contraction of smooth muscle cells • induction of bronchodilatation • used experimentaly

  16. Comparison of numbers of drugs used in therapy of bronchial asthma

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