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9. A comparative pharmacotherapeutic study of inhalers used in the management of asthma in south west Nigeria
M.K. Omole,A. Adewumi
International Journal of Pharmaceutical and Biomedical Research (IJPBR) , 2011,
Abstract: This study was carried out at Oluyoro Catholic Hospital, Oke-Ofa, Ibadan, Nigeria. Retrospective and prospective studies were carried out to compare the pharmacotherapeutic efficacy of three anti asthmatic inhalers. The retrospective study involved 120 medical records of asthmatic patients studied. Seventy two (72) (60%) were in-patients while 48 (40%) were out-patients. Eighty four (84) (70%) patients were on Inhalers with oral anti asthmatic drugs with 9 (10.7%) on Esiflo Inhaler, 72 (85.7%) on Salbutamol inhaler and 3 (3.6%) were on Beclomethasone inhaler. Prospective study was carried out with questionnaires administered to 40 asthmatic patients with 100% respondents. 28 (70%) were on oral anti asthmatic drugs, while 12 (30%) were on inhalers combined with oral anti asthmatic drugs. Eighteen (18) of the 40 respondents volunteered to participate in the retrospective study involving Salmeterol/Fluticasone, Salbutamol and Beclomethasone inhalers. After 60 min, those on Esiflo inhaler had highest PEF values of 280L/min followed by those on Becotide inhaler with PEF value of 240L/min and those on Ventolin with the least PEF value of 220L/min. After 24 h the patient on Esiflo inhalers used the medication once with PEF increase to 320L/min followed by those on Becotide inhalers who used the medication twice with PEF increased to 290L/min and patients on Ventolin inhalers used the medication twice with PEF increased to 280L/min.
Anti-asthma medication prescribing to children in the Lombardy Region of Italy: chronic versus new users
Marina Bianchi, Antonio Clavenna, Marco Sequi,, Angela Bortolotti, Ida Fortino, Luca Merlino, Maurizio Bonati
BMC Pulmonary Medicine , 2011, DOI: 10.1186/1471-2466-11-48
Abstract: The analysis involved prescriptions given to 6-17 year olds between 2003 and 2005 in Italy's Lombardy Region. The youths were classified as potential asthmatics, based on the different degree of drug utilization: occasional, low or high users, and grouped as 'new onset' or 'chronic' cases based on the duration of therapy dispensed. The analysis of prescriptions and hospitalization rate of these groups provided an estimate of the 2005 asthma prevalence and incidence and allowed an estimation of the level of appropriateness of treatments.During 2005, the estimated incidence of potential asthmatics was 0.8% and the estimated prevalence was 3.5%. When viewed retrospectively for two years, records showed that 47% of potential asthmatics received prescriptions also during 2004 and 30% also during 2003. During the three years considered, 7.5%, 2.8%, and 1.5% of high, low, and occasional users, respectively, were hospitalized for asthma. The most important inappropriateness found was the prescription of long acting beta adrenergics as first time treatment.This study allowed a proxy of asthma incidence, prevalence, and severity. The analyses highlighted a low compliance with the guidelines, suggesting that educational interventions are needed to obtain a more rational management of childhood asthma, especially in subjects starting therapy.Asthma is one of the leading chronic childhood diseases, and its prevalence in Italy remained largely stable between 1995 and 2002 (9%) [1]. Prior to school age many children experience recurrent episodes of wheezing and cough. These symptoms are frequently transient, and 60% of preschoolers are asymptomatic by age six [2,3]. For this reason, children have a higher overall prevalence of anti-asthmatic prescriptions compared to adolescents. Regarding asthma therapy, international guidelines recommend inhaled corticosteroids (ICS) for long-term control of persistent asthma and short acting β2 adrenergic (SABA), such as salbutamol, as first ch
ANALYSIS OF PRESCRIPTION PATTERN AND DRUG UTILIZATION IN ASTHMA THERAPY
Patel Pinal D.,Patel R.K.,Patel N.J.
International Research Journal of Pharmacy , 2012,
Abstract: This drug utilization or prescription-monitoring study was conducted to evaluate the drug-prescribing trend of anti-asthmatic drugs in retailed pharmacy outlets during 2009 and 2011 in urban and rural area of Saurashtra region, Gujarat, India. The study was conducted on 601 patients, using a developed prescription auditing Performa. Data was recorded from the co-operating patients by interviewing and information was filled in the performa. The data suggested that punctuality in professionalism like mentioning own (physicians) name, patients name, diagnosis and minimum qualification of MD/MS was observed to be higher in urban than the rural. There was no significant sex difference. Bronchial asthma was found to be more prevalent in the age group 41 to 60 years. Patients were found to consult the doctor 2 to 7 days after symptoms and pay consulting fee more than Rs.20=00. The collected information suggested that bronchodilators were the most frequently prescribed anti-asthmatic drugs followed by corticosteroids and methylxanthine preparation. Analysis of prescription revealed that multiple drug therapy was opted for a significant number of patients as compared to single drug therapy. In combination therapy, the three-drug combination was the most often prescribed. Number of partial purchase of drugs as per the prescriptions was found to be higher in rural area than urban area. Lack of money was one of the reasons for partial prescription. Thus, it can be concluded that the present prescribing pattern of antiasthmatics in Saurashtra region does not completely meet standard guidelines for the asthma treatment. Hence there is a need of awareness amongst the physicians of Saurashtra region so that they can follow the guidelines while treating asthma. Also the patients must be encouraged to complete whole treatment for improving the health. It has been also concluded that a study may be more meaningful to further improve the dispensing practices of the pharmacist.
Cellular Profiles in Peripheral Blood Accompanying Particular Asthmatic Response Types  [PDF]
Zdenek Pelikan
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.36088
Abstract: Background: Patients with allergic bronchial asthma develop various asthmatic response types to bronchial challenge with allergen, such as immediate (IAR), late (LAR), dual late (DLAR) or delayed (DYAR), displaying different clinical, immunologic and pharmacologic features. This study deals with count changes of particular blood cells accompanying the IAR, LAR and DYAR. Methods: In 63 patients developing 22 IAR, 26 LAR and 15 DYAR, the repeated allergen challenges were supplemented with recording of blood cell counts, Th1/Th2 ratio, leukotrines B4 (LTB4) and C4 (LTC4), eosinophil cationic protein (ECP), myeloperoxidase (MPO), and histamine in blood, and intracellular IFN-γ and IL-4 in peripheral blood mononuclear cells. Results: The IAR was accompanied by increased eosinophil and basophil counts, increased serum concentrations of histamine, LTC4 and ECP, decreased Th1/Th2 ratio in favour of Th2 cells, and increased intracellular IL-4. The LAR was associated with increased eosinophil and neutrophil counts, increased serum concentrations of LTC4 and LTB4, unchanged Th1/Th2 ratio, and increased intra-cellular IL-4. The DYAR was accompanied by increased total leukocyte, neutrophil, monocyte, lymphocyte and thrombocyte counts, increased serum concentrations of LTB4 and MPO, increased Th1/Th2 ratio in favour of Th1 cells, and increased intracellular IFN-γ. Conclusions: These results provide evidence for different involvement of particular blood cell types and different hypersensitivity mechanisms in IAR, LAR and DYAR. The monitoring of peripheral blood cell counts seems to be an useful supplementary parameter to the bronchial challenge with allergen.
Calidad de vida en el adolescente asmático
Aguirre Pérez,Orquídea; álvarez Carmenate,Marlene; González Ortega,Elizabeth; Dotres Martínez,Carlos P.; Balado Sansón,Rogelio Miguel; Sardi？as Arce,María Elena;
Revista Cubana de Medicina General Integral , 2010,
Abstract: introduction: the improvement in quality of life is a key element in treatment of asthmatic child-adolescent. objective: to identify the affection provoking the bronchial asthma in the quality of life of the asthmatic adolescent. methods: a prospective longitudinal and descriptive study was conducted in 103 asthmatic adolescents diagnosed with intermittent slight asthma from the "antonio josé de sucre" secondary basic school in the cojimar place, from january 1, to december 31, 2006. results: the major symptoms included cough, dyspnea and sibilation and the more frequent nuisances were the tiredness, profound breathlessness and the feeling of lack of air. there was predominance of male sex and ages of 12 and 13 years. the great number of responses of emotional function alterations it was concentrated in the lowest categories of affection level and the responses on motor activity limitation were qualified as very much, much, enough and regular. in quality of life there was predominance of moderate affection. the moderate persistent asthma was mainly perceived in the severe quality of life state.
Efectividad de un programa de ejercicios respiratorios como tratamiento a pacientes asmáticos severos adultos
Boris Andino,Nuria; Rodríguez Vázquez,Juan Carlos;
Revista Cubana de Medicina , 2007,
Abstract: a retrospective and prospective study was performed with 137 severe asthmatic patients, 77 of them participated in a program of respiratory exercises (experimental group) for 15 days in a row in class sessions from 15 to 60 minutes. they continued doing the exercises at home during the year the investigation lasted, and they were compared with 66 patients that did not carry out this activity (control group). all the patients underwent functional tests at the beginning and a year after concluding the treatment. there was a predominance of female white patients aged 40-55. a reduction of admissions, as well as of the frequency of asthma crises was evidenced among those patients that practiced the respiratory exercises, which was not so in the control group. it was observed an improvement of the night symptoms and the spirometric variables were more evident in the experimental group. it was proved that a year later, most of the patients were still doing the exercises with a very good level of acceptance. it was concluded that a systematic practice of a program of respiratory exercises is very beneficial for asthmatic patients.
Serum 25 Hydroxy Vitamin D Levels In Adult Asthmatic Patients
Mostafa M. Shaaban*, Manal Hashem
Egyptian Journal of Hospital Medicine , 2012,
Abstract: Purpose: Patients with chronic lung disease as asthma appear to be at increased risk for vitamin D deficiency for reasons that are not clear. Methods: A cross sectional study including 75 asthmatic adults aged older than 18 years and 75 adults healthy control aged older than 18 years (35 males and 40 females for both groups) assessing the relationship between serum 25 hydroxy vitamin D levels and lung function. Result: In our study only (12 31%) of our asthmatic adults had sufficient vitamin D levels ( ≥ 30 ng/ml) , wherase (85%) of healthy control subjects expressed sufficient levels. Vitamin D deficiency (<20 ng/ml) was observed in 59 (78.66%) asthmatic patients (17.28 ±2.4 ng/ml). Deficiency was not observed in controls (33.67±6.3). In asthmatic patients Serum 25(OH) vitamin D was positively correlated with forced expiratory volume in 1 second % ( FEV1 %) predicted &forced expiratory/forced vital capacity ratio ( FEV1//FVC)(P=<0.05 for all). There was no significant association between serum vitamin D level and eosinophil count. Conclusion: Reduced vitamin D levels are highly prevalent in adult asthmatic patients and are associated with impaired pulmonary functions
Cross Sectional Study: Prevalence of Allergic Rhinitis among Adult Asthmatic Patients in Kuwait.
Abdullah Alsaeedi,Adel Abdelhamy,Fares Alkhaldy
- , 2018, DOI: 10.4066/2591-7951.1000055
Abstract: Background: Allergic rhinitis is prevalent co-morbidity among asthmatic patients. The literature has suggested that it is responsible for poor asthma control. Also, it was found to be an important risk factor for developing of asthma in general population. In Kuwait there are no previous studies that estimated the prevalence of such an association. This study conducted to evaluate the prevalence of allergic rhinitis on adult bronchial asthma in a single center in Kuwait and to examine other common associations. Material and methods: This is a cross sectional study in a single center to evaluate the prevalence and allergic rhinitis and its effect on asthma management among adults. The data was collected through a distribution of an online questionnaire the score for allergic rhinitis (SFAR) to known asthmatic patients who were diagnosed previously with bronchial asthma in a period of six weeks between January and February 2018. Analyzed, discussed and compared to other relevant study. Results: 494 asthmatic patients participated in the questionnaire in a period of 6 weeks. 74.7% were females and 25.3% was males. 39.7% of patients were obese and 13% were smokers. The vast majority of asthmatic patients experienced symptoms of allergic rhinitis in the past 12 months. The most common symptoms experienced were; sneezing (48%), nose itching (45.5%), and cough (35.6%), moreover, 34.4% had runny nose. and 20.9% have had their eyes itching. Interestingly sneezing showed a decreasing prevalence as getting older among males but not females, also runny nose showed biphasic course among age groups. Two thirds (69.4%) of the patients were not using any rhinitis medications. Conclusion: Allergic rhinitis is a common co-morbidity among asthmatic adult patients in our study in Kuwait. The vast majority of patients were not using their rhinitis treatment. Better patient education and adherence to treatment is warranted. Further studies needed to assess the impact of rhinitis treatment on asthma control in Kuwait
Cytokines Released from Allergen-Stimulated Blood Cells during the Delayed Asthmatic Response to Allergen Challenge  [PDF]
Zdenek Pelikan
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.56049
Abstract:

Background: Bronchial asthma patients may develop various asthmatic response types to bronchial challenge with allergen, such as immediate (IAR), late (LAR), dual (DAR) or delayed (DYAR), due to different immunologic mechanisms. The DYAR, beginning between 26-32 hrs and lasting up to 56 hrs after the allergen challenge, differs from the IAR, LAR and DAR in clinical, diagnostic and immunologic aspects. The aim of this study was to investigate the concentrations of the particular intracellular cytokines released by blood cells stimulated with relevant allergens “in vitro”, before and during the DYAR. Methods: In 23 patients, the repeated DYAR (p < 0.001) was supplemented with cytokine determination in the supernatants of the blood cells stimulated with relevant allergens before and up to 72 hours after the bronchial challenge, by means of enzyme-linked immunoassay. Results: The significantly elevated pre-challenge concentrations (p < 0.05) of IL-2, IL-17, IFN-γ and G-CSF released by allergen-stimulated blood cells “in vitro” were recorded in the DYAR patients as compared with healthy controls. The significantly increased post-challenge concentrations (

A Study to Assess the Psychosocial Problems and Quality of Life of Parents with Asthmatic Children in Opd’s of Ramaiah Hospitals, Bengaluru  [PDF]
Somashekar Ankanahalli Ramu, Arpitha Panduranga, S. Akarsh
Open Journal of Pediatrics (OJPed) , 2018, DOI: 10.4236/ojped.2018.81007
Abstract: The study was undertaken to assess the level of psychosocial problems and quality of life of parents with asthmatic children in Ramaiah hospitals, Bengaluru. Statement of the problem: “A study to assess the psychosocial problems and quality of life of parents with asthmatic children in opd’s of Ramaiah hospitals, Bengaluru”. Objectives of the study: 1) To assess the level of psychosocial problems and level of quality of life of parents with asthmatic children. 2) To find the correlation between scores of psychosocial problem and quality of life among parents with asthmatic children. 3) To find the association between level of psychosocial problem and selected socio demographic variables. 4) To find the association between level of quality of life and selected socio-demographic variable. Method: A descriptive survey approach was used for the study. Purposive sampling technique was used to select 50 parents with asthmatic children. Data was collected through interview schedule by using structured rating scale to assess psychosocial problems and quality of life. Data was collected and analyzed using descriptive and Inferential statistics in terms of frequencies, Percentage, Mean, Mean percentage, Standard deviation, Karl Pearson’s correlation co-efficient and chi-square test. Findings: The major findings of the study indicated that majority of the parents with asthmatic children that is 33 (66%) were having moderate psychosocial problems and 16 (32%) were having mild psychosocial problem and 1 (2%) were having severe psychosocial problem and 38 (76%) were having good quality of life, 8 (16%) were having better quality of life and 4 (8%) were having poor quality of life. Karl Pearson’s correlation co-efficient test revealed that there is a correlation that exists between
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