Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Expert Opin Pharmacother ; 21(16): 1991-2010, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32686969

ABSTRACT

INTRODUCTION: Asthma is a heterogeneous syndrome with variable phenotypes. Reversible airway obstruction and airway hyper-responsiveness often with an atopic or eosinophilic component is common in the elderly asthmatic. Asthma chronic obstructive pulmonary disease overlap syndrome (ACOS), a combination of atopy-mediated airway hyper-responsiveness and a history of smoking or other environmental noxious exposures, can lead to some fixed airway obstruction and is also common in elderly patients. Little specific data exist for the treating the elderly asthmatic, thus requiring the clinician to extrapolate from general adult data and asthma treatment guidelines. AREAS COVERED: A stepwise approach to pharmacotherapy of the elderly patient with asthma and ACOS is offered and the literature supporting the use of each class of drugs reviewed. EXPERT OPINION: Inhaled, long-acting bronchodilators in combination with inhaled corticosteroids represent the backbone of treatment for the elderly patient with asthma or ACOS . Beyond these medications used as direct bronchodilators and topical anti-inflammatory agents, a stepwise approach to escalation of therapy includes multiple options such as oral leukotriene receptor antagonist or 5-lipoxygense inhibitor therapy, oral phosphodiesterase inhibitors, systemic corticosteroids, oral macrolide antibiotics and if evidence of eosinophilic/atopic component disease exists then modifying monoclonal antibody therapies.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Asthma/drug therapy , Bronchodilator Agents/therapeutic use , Leukotriene Antagonists/therapeutic use , Muscarinic Antagonists/therapeutic use , Administration, Inhalation , Adrenal Cortex Hormones/administration & dosage , Adult , Aged , Anti-Inflammatory Agents/administration & dosage , Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome/drug therapy , Humans , Leukotriene Antagonists/administration & dosage , Macrolides/administration & dosage , Macrolides/therapeutic use , Medication Adherence , Metered Dose Inhalers , Muscarinic Antagonists/administration & dosage , Smoking/adverse effects
2.
J Investig Med ; 67(7): 1029-1041, 2019 10.
Article in English | MEDLINE | ID: mdl-31352362

ABSTRACT

Asthma is a complex inflammatory disease with many triggers. The best understood asthma inflammatory pathways involve signals characterized by peripheral eosinophilia and elevated immunoglobulin E levels (called T2-high or allergic asthma), though other asthma phenotypes exist (eg, T2-low or non-allergic asthma, eosinophilic or neutrophilic-predominant). Common triggers that lead to poor asthma control and exacerbations include respiratory viruses, aeroallergens, house dust, molds, and other organic and inorganic substances. Increasingly recognized non-allergen triggers include tobacco smoke, small particulate matter (eg, PM2.5), and volatile organic compounds. The interaction between respiratory viruses and non-allergen asthma triggers is not well understood, though it is likely a connection exists which may lead to asthma development and/or exacerbations. In this paper we describe common respiratory viruses and non-allergen triggers associated with asthma. In addition, we aim to show the possible interactions, and potential synergy, between viruses and non-allergen triggers. Finally, we introduce a new clinical approach that collects exhaled breath condensates to identify metabolomics associated with viruses and non-allergen triggers that may promote the early management of asthma symptoms.


Subject(s)
Allergens/immunology , Asthma/immunology , Asthma/virology , Environment , Viruses/immunology , Air Pollution/adverse effects , Animals , Humans , Smoking/adverse effects
SELECTION OF CITATIONS
SEARCH DETAIL
...