TAILIEUCHUNG - Critical care medicine - part 5

Hen suyễn 63 rối loạn testinal và tăng hoạt động aminotransferase huyết thanh. Thuốc gây ra bệnh lupus và viêm mạch Churg-Strauss đã được báo . Zileuton (Zyflo) là khiêm tốn hiệu quả cho điều trị duy trì, nhưng nó được thực hiện bốn lần một ngày và bệnh nhân phải được theo dõi độc tính gan. | Asthma 63 testinal disturbances and increased serum aminotransferase activity. Drug-induced lupus and Churg-Strauss vasculitis have been reported. 4. Zileuton Zyflo is modestly effective for maintenance treatment but it is taken four times a day and patients must be monitored for hepatic toxicity. D. Cromolyn Intal and nedocromil Tilade 1. Cromolyn sodium an inhibitor of mast cell degranulation can decrease airway hyperresponsiveness in some patients with asthma. The drug has no bronchodilating activity and is useful only for prophylaxis. Cromolyn has virtually no systemic toxicity. 2. Nedocromil has similar effects as cromolyn. Both cromolyn and nedocromil are much less effective than inhaled corticosteroids. E. Theophylline 1. Oral theophylline has a slower onset of action than inhaled beta2 agonists and has limited usefulness for treatment of acute symptoms. It can however reduce the frequency and severity of symptoms especially in nocturnal asthma and can decrease inhaled corticosteroid requirements. 2. When theophylline is used alone serum concentrations between 8-12 mcg mL provide a modest improvement is FEV1. Serum levels of 1520 mcg mL are only minimally more effective and are associated with a higher incidence of cardiovascular adverse events. F. Oral corticosteroids are the most effective drugs available for acute exacerbations of asthma unresponsive to bronchodilators. 1. Oral corticosteroids decrease symptoms and may prevent an early relapse. Chronic use of oral corticosteroids can cause glucose intolerance weight gain increased blood pressure osteoporosis cataracts immunosuppression and decreased growth in children. Alternate-day use of corticosteroids can decrease the incidence of adverse effects but not of osteoporosis. 2. Prednisone prednisolone or methylprednisolone Solu-Medrol 40-60 mg qd for children 1-2 mg kg day to a maximum of 60 mg day. Therapy is continued for 3-10 days. The oral steroid dosage does not need to be tapered after short-course

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