What Are the Clinical Implications of β2-adrenoreceptor Polymorphisms for the Treatment of Asthma?

Weinberger, Miles

doi:10.5863/1551-6776-8.1.6

Cited by 1 publication

(3 citation statements)

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“…FEV 1 before and after 6 minutes of treadmill exercise at a speed and incline sufficient to maintain the heart rate at 85% of aerobic capacity in a 15-year-old male with severe chronic asthma and exercise intolerance. 34 The results are the mean of two tests performed on different days while the patient was being treated with salmeterol and high dose inhaled corticosteroids and two tests subsequent to stopping the salmeterol and adding theophylline to the same dose of inhaled corticosteroids. Each exercise test was preceded by 4 inhalations of pirbuterol (a therapeutic equivalent of albuterol) from a Maxair Autohaler.…”

Section: Evolution Of Effective Pharmacotherapymentioning

confidence: 99%

“…Alternatively, theophylline can be used as an additive agent in the sub-group of individuals who develop salmeterol-induced loss of response to the rescue or bronchoprotective effects of albuterol or pirbuterol. 34 Montelukast may be useful for very mild daily symptoms in young children where delivery of an inhaled medication is problematic.…”

Section: Current State Of the Art For Pharmacotherapy For Asthmamentioning

confidence: 99%

“…A consequence of down-regulation is the loss of bronchopro-tective effect of shorter-acting β2-agonists when used as rescue medications or to prevent exercise-induced bronchospasm ( Figure 3). 34 Other moieties with unique mechanisms of action have been introduced. Cromolyn sodium (disodium cromoglycate) and nedocromil pharmacologically act to inhibit the release of mediators from mast cells and basophils.…”

Section: Evolution Of Effective Pharmacotherapymentioning

confidence: 99%

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Managing Asthma: Past, Present, and Future

Weinberger

2004

The Journal of Pediatric Pharmacology and Therapeutics

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Asthma has been recognized in the medical literature for almost 2000 years. Modern pharmacotherapy for asthma began with the commencement of the 20 th century following the development of epinephrine and the demonstration of its effectiveness for acute symptoms of asthma. Progressive development of this class of bronchodilator medication has provided greater β2 specificity and longer duration of action. Corticosteroids were introduced about 50 years ago. As a systemic medication, they provided anti-inflammatory activity that continues to be essential for exacerbations of symptoms that are unresponsive to a bronchodilator. Corticosteroids were subsequently developed as inhaled agents for long-term maintenance therapy. The availability of corticosteroids with high topical effect has permitted the use of smaller doses with minimal systemic effect; therefore, the inhaled corticosteroids have become the most effective monotherapeutic agents for chronic asthma.Both theophylline and long-acting β2 agonists (e.g., salmeterol) provide additive clinical effect to small doses of inhaled corticosteroids. This effect is greater than that achieved with larger doses of the inhaled steroid used alone. A new approach to managing allergic asthma is now available in the form of a monoclonal antibody directed against immunoglobulin E (IgE). This agent, omalizumab, binds to circulating IgE, thereby preventing IgE from binding to mast cells. This subsequently prevents the release of mediators for bronchospasm and inflammation. Under investigation are monoclonal antibodies to modify the effects of interleukins involved in the inflammatory process of asthma. Phosphodiesterase inhibitors that are more specific than theophylline and monoclonal antibodies that prevent the attachment of rhinovirus to respiratory mucosa are being studied. Since rhinoviruses are major causes of acute exacerbations of asthma, these and other measures to prevent or modify the common cold provide great potential for further improvement in the outcome of asthma.

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Section: Evolution Of Effective Pharmacotherapymentioning

confidence: 99%

Section: Current State Of the Art For Pharmacotherapy For Asthmamentioning

confidence: 99%

Section: Evolution Of Effective Pharmacotherapymentioning

confidence: 99%

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