Non steroid asthma treatment

Dr. Murphy is a recognized national leader in allergy and immunology. He is the founding Chief of the Allergy Section of PENN MEDICINE Chester County Hospital. He is a fellow and a member of the Board of Directors of the American Academy of Allergy Asthma and Immunology and as such has played an integral role in various national projects regarding Allergy/Immunology medical education, practice and patient care. Regionally Dr. Murphy has been intimately involved with advocacy related to injectable epinephrine available in schools, newborn screening for immune system disorders (SCID) and accurate physician representation of their training and credentials. He has been on the Alumni Board of the Penn State University College of Medicine and served as its President-elect, President and Past President. He is a past member of the Board of Regents of the Pennsylvania Allergy Association, past President of the Philadelphia Allergy Society, past representative for Allergy to the House of Delegates, and the Specialty Leadership Cabinet of the Pennsylvania Medical Society (2010 – present).

Sacks et al. (2005) reported the case of a 72-year-old man, described as professionally successful, intelligent, and cultivated, with polymyalgia rheumatica, who after being treated with prednisone developed a psychosis and dementia , which several behavioral neurology and neuropsychiatry consultants initially diagnosed as early dementia or Alzheimer's disease . [13] Large dosage variations in the patient's medication (including a self-increased dosage from 10 mg/day to as much as 100 mg/day for at least 3 months) produced extreme behavioral changes, from missed appointments to physical altercations, and eventually admission to a psychiatric ward and later to a locked Alzheimer facility. During this time, neuropsychological testing showed a decline in the patient's previously superior IQ as well as deficits in memory, language, fluency, and visuospatial function, which given the patient's age was considered to be compatible with early dementia. When the steroid treatment ended after a year, the patent's confusion and disorganized appearance stopped immediately. Within several weeks, testing showed strong improvement in almost all cognitive functions. His doctors were surprised at the improvement, since the results were inconsistent with a diagnosis of dementia or Alzheimer's. Testing after 14 months showed a large jump in Full Scale IQ from 87 to 124, but mild dysfunction in executive function, memory, attentional control, and verbal/nonverbal memory remained. [13]

Whether airway hyperresponsiveness is a symptom of airway inflammation or airway remodeling, or whether it is the cause of long-term loss of lung function, remains controversial. Some investigators have hypothesized that aggressive treatment with anti-inflammatory therapies improves the long-term course of asthma beyond their salutary effects on parameters of asthma control and rates of exacerbation over time. 13 This contention has been supported by an observational study 14 that found long-term exposure to ICS was associated with an attenuation of the accelerated decline in lung function previously reported in asthmatics; more studies are required to substantiate these findings.

Family history is a risk factor for asthma, with many different genes being implicated. [67] If one identical twin is affected, the probability of the other having the disease is approximately 25%. [67] By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1 , IL10 , CTLA-4 , SPINK5 , LTC4S , IL4R and ADAM33 , among others. [68] Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested. [68] In 2006 over 100 genes were associated with asthma in one genetic association study alone; [68] more continue to be found. [69]

SOURCES:
American Academy of Asthma, Allergy & Immunology: "Asthma" and "Allergy and Asthma Drug Guide."
National Jewish Medical and Research Center: "Inhaled Medication with a Metered Dose Inhaler (MDI)." 
Asthma Society of Canada: "How to Use Your Inhaler."
Science Daily: "New Asthma Inhaler Propellant Effective, but Costlier."
Children's Hospital Boston: "Allergy Treatment."
Boehringer Ingelheim: "US FDA Expands Approval of Tiotropium Respimat® for Maintenance Treatment of Asthma in Children."
FDA. Prescribing Information: Spiriva Respimat.

Non steroid asthma treatment

non steroid asthma treatment

Family history is a risk factor for asthma, with many different genes being implicated. [67] If one identical twin is affected, the probability of the other having the disease is approximately 25%. [67] By the end of 2005, 25 genes had been associated with asthma in six or more separate populations, including GSTM1 , IL10 , CTLA-4 , SPINK5 , LTC4S , IL4R and ADAM33 , among others. [68] Many of these genes are related to the immune system or modulating inflammation. Even among this list of genes supported by highly replicated studies, results have not been consistent among all populations tested. [68] In 2006 over 100 genes were associated with asthma in one genetic association study alone; [68] more continue to be found. [69]

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