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儿童哮喘的药物治疗

Drug therapy of childhood asthma.

作者信息

Balachandran A, Shivbalan S, Subramanyam L

机构信息

Kanchi Kamakoti Childs Trust Hospital, Chennai.

出版信息

Indian J Pediatr. 2001 Sep;68 Suppl 4:S12-6.

Abstract

Drug therapy is used to prevent and control asthma, and also to reduce the frequency and severity of its exacerbations, and reverse airflow obstruction. Asthma medications are thus categorized into two general classes--bronchodilators (relievers) and anti-inflammatory drugs (preventers). Short acting beta2-agonists is the therapy of choice for relief of acute symptoms and prevention of exercise induced bronchospasm (EIB). Corticosteroids are the most potent and effective anti-inflammatory medication currently available. Inhaled form is used in the long-term control of asthma. Systemic corticosteroids are used to gain prompt control of the disease when initiating long-term therapy. Long acting bronchodilator used concomitantly with anti-inflammatory medications for long-term control of symptoms, especially nocturnal symptoms. Ipratropium bromide may provide some additive benefit to inhaled beta2-agonists in severe exacerbations. Sustained release theophylline is a mild to moderate bronchodilator used principally as adjuvant to inhaled corticosteroids for prevention of nocturnal asthma. Leukotriene modifiers may be considered as an alternative therapy to inhaled corticosteroids or cromolyn or nedocromil.

摘要

药物治疗用于预防和控制哮喘,还可减少哮喘发作的频率和严重程度,并逆转气流阻塞。因此,哮喘药物分为两大类——支气管扩张剂(缓解剂)和抗炎药物(预防剂)。短效β2激动剂是缓解急性症状和预防运动诱发性支气管痉挛(EIB)的首选治疗方法。皮质类固醇是目前可用的最有效和最具效力的抗炎药物。吸入剂型用于哮喘的长期控制。在开始长期治疗时,全身用皮质类固醇用于迅速控制病情。长效支气管扩张剂与抗炎药物联合使用,用于长期控制症状,尤其是夜间症状。在严重发作时,异丙托溴铵可能会给吸入性β2激动剂带来一些附加益处。缓释茶碱是一种轻度至中度支气管扩张剂,主要用作吸入性皮质类固醇的辅助药物,用于预防夜间哮喘。白三烯调节剂可被视为吸入性皮质类固醇或色甘酸钠或奈多罗米的替代疗法。

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