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Krómóglýköt ( Chomoglycates)

Krómóglýköt ( Chomoglycates). Sigurður Ragnarsson stud. med. Langtíma meðferð við astma. Barksterar budesonide fluticasone Leukotrien blokkar safirlukast montelukast β 2 -agonistar langvirkir formoterol salmeterol stuttvirkir (per necesitas) Methylxanthines theophylline

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Krómóglýköt ( Chomoglycates)

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  1. Krómóglýköt (Chomoglycates) Sigurður Ragnarsson stud. med.

  2. Langtíma meðferð við astma • Barksterar • budesonide • fluticasone • Leukotrien blokkar • safirlukast • montelukast • β2-agonistar • langvirkir • formoterol • salmeterol • stuttvirkir (per necesitas) • Methylxanthines • theophylline • aminophylline • Krómóglykat

  3. Krómóglýköt • Fyfirbyggjandi meðferð • Minnka immediate og late-phase astma svörun og minnkar hyperreactivity.

  4. Verkunarmáti • Ekki vitað nákvæmlega hvernig virkar. • Eru ekki bronchodilators, hafa ekki áhrif á slétta vöðva né hindra sléttvöðva-stimulants. • “Mast cell stabilizer” • Minnkar neuronal reflexa

  5. Ábendingar • Áhrifarík meðferð í: • antigentengdum (atópískum) astma • irritanttengdum astma • áreynslutengdum astma • Meiri áhrif í börnum en fullorðnum.

  6. Lyfjafræði • Lélegt frásog um meltingarveg • Gefið sem innúði. • T ½ 90 mín. • Rapport um urticariu og anaphylaxa

  7. Krómóglyköt Cromylin sodium Nedochromil börn og fullorðnir fullorðnir

  8. ICS versus SCGinhaled corticosteroids vs. sodium cromoglycate • ICS: færri tilvik af astmaversnunum • betri lungnafunction • færri astmaeinkenni • minni notkun PN berkjuvíkkandi lyfja • lítill munur á alvarleika aukaverkuna

  9. Cochrane og krómóglýköt • Publication bias • Sami fjöldi einkennalausra daga • “no or only minimal benefit for DSCG compared to placebo as maintanance therapy for childhood asthma” • “day cough, day wheezing, use of rescue oral steroids, and hospital admission, failed to reveal any significant group differences between DSCG and placebo”

  10. Heimildir • Guevara JP. Ducharme FM. Keren R. Nihtianova S. Zorc J. Inhaled corticosteroids versus sodium cromoglycate in children and adults with asthma. [Review] [121 refs] [Journal Article. Meta-Analysis. Review] Cochrane Database of Systematic Reviews. (2):CD003558, 2006. • Spooner CH. Spooner GR. Rowe BH. Mast-cell stabilising agents to prevent exercise-induced bronchoconstriction. [Review] [79 refs] [Journal Article. Meta-Analysis. Review] Cochrane Database of Systematic Reviews. (4):CD002307, 2003. • van der Wouden JC. Tasche MJ. Bernsen RM. Uijen JH. de Jongste JC. Ducharme FM. Inhaled sodium cromoglycate for asthma in children. [Review] [180 refs] [Journal Article. Review] Cochrane Database of Systematic Reviews. (3):CD002173, 2003. • Kelly K. Spooner CH. Rowe BH. Nedocromil sodium vs. sodium cromoglycate for preventing exercise-induced bronchoconstriction in asthmatics. [Review] [28 refs] [Journal Article. Review] Cochrane Database of Systematic Reviews. (4):CD002731, 2000. • Tasche MJ. Uijen JH. Bernsen RM. de Jongste JC. van der Wouden JC. Inhaled disodium cromoglycate (DSCG) as maintenance therapy in children with asthma: a systematic review. [see comment]. [Review] [58 refs] [Journal Article. Review] Thorax. 55(11):913-20, 2000 Nov. UI: 11050259 • Chipps BE. Chipps DR. Approach to the difficult pediatric asthmatic. [Review] [32 refs] [Journal Article. Review] Current Opinion in Pulmonary Medicine. 5(1):52-7, 1999 Jan. • Godfrey S. Konig P. Inhibition of exercise-induced asthma by different pharmacological pathways. [Review] [23 refs] [Clinical Trial. Journal Article. Review] Thorax. 31(2):137-43, 1976 Apr.

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