Asthma treatment options for children 2-5 years of age Step 1 Intermittent reliever therapy SABA as needed Step 2 Low-dose controller and Low-dose ICS as-needed reliever medication Intermittent ICS (second choice if seasonal symptoms) LTRA Step 3 Additional controller and Medium-dose ICS as-needed reliever medication Low-dose ICS and LTRA Step 4 Refer to specialist (paediatrician, paediatric allergologist or paediatric pulmonologist) SABA = short-acting [beta.sub.2]-agonist; ICS = inhaled corticosteroid; LTRA = leukotriene receptor antagonist
. Table 6.
Cavanillas, "The leukotriene receptor antagonist
montelukast and its possible role in the cardiovascular field," European Journal of Clinical Pharmacology, vol.
Gaddy et al., 15 showed that intravenous leukotriene receptor antagonists
could produce a 22% improvement in [FEV.sub.1] from baseline in those with stable asthma with a baseline [FEV.sub.1] of 50%-80% predicted.
Hashim, "Cysteinyl leukotriene receptor antagonist
montelukast ameliorates acute lung injury following haemorrhagic shock in rats," European Journal of Cardio-Thoracic Surgery, vol.
Administration of an inhaled SABA 15 minutes prior to exercise and a variety of warm-up exercises act as a first-line treatment, with an inhaled corticosteroid or a leukotriene receptor antagonist
effective for those who do not respond to the SABA alone.
Combination therapy typically involves antihistamines to block the histamine released from mast cells and basophils, LTRAs (leukotriene receptor antagonists
) to block leukotrienes, and nasal corticosteroids to block the various inflammatory mediators that participate in allergic reactions.
Leukotriene receptor antagonists
and 5-lipoxygenase inhibitors are used to treat asthma patients, about 15% of whom are sensitive to cyclooxygenase inhibitors.
Montelukast is a leukotriene receptor antagonist
. More simply put, it works by keeping substances in the body called leukotrienes from binding to their target point in the human airway.
Singulair is a leukotriene receptor antagonist
commonly prescribed for the prevention and treatment of asthma and for the treatment of allergic rhinitis.
Alternative -- Cromolyn, leukotriene receptor antagonist
, or theophylline (serum level 5-12 mcg/mL).
The leukotriene receptor antagonist
montelukast in the treatment of chronic idiopathic urticaria.
Although Astra has a number of well-established anti-asthma products, Zeneca had no such activities until the recent development of Accolate, a leukotriene receptor antagonist