Beta-2 agonist discussions in asthma and a review of current data
Küçük Resim Yok
Tarih
2011
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Güncel kılavuzlar doğrultusunda astım tedavisinde kontrol edici olarak ilk seçenek inhale steroidlerdir. Bununla birlikte özellikle hava yolu obstrüksiyonu bulunan pek çok hastada gerek semptom giderici olarak, gerekse ek kontrol edici ilaç olarak hava yolu düz kaslarında relaksasyona yol açan bronkodilatörlere ihtiyaç duyulmaktadır. Hem kısa etkili hem de uzun etkili beta-2 agonistler (SABA ve LABA) astımda kullanılan bronkodilatörler arasında ayrı bir öneme sahiptir. İyi bilinen yararlarına rağmen, son yıllarda LABA’ların güvenliliği üzerine artan sayıda makale yayınlanmıştır. Bununla beraber, LABA monoterapisi ile ilişkili olduğu bildirilen risk artışı, standart tedavi olarak LABA ile kombine inhale kortikosteroid alan hastalarda gözlenmemiştir. Astım mortalitesi dahil olmak üzere, riskler ile ilgili tartışma sürerken, inhale kortikosteroide LABA eklenmesinin yararları geniş şekilde dokümante edilmiştir. Farmakogenetik gelişmeler sayesinde, birçok çalışmada etkinlik ve güvenliliği gösterilmiş olan bu ilaçların bazı istenmeyen yan etkilerinin potansiyel genetik temeli olabileceğine de dikkat çekilmiştir. Sonuç olarak; LABA’lar inhale kortikosteroidler ile birlikte kullanıldığında, astımda semptomların giderilmesi ve akciğer fonksiyonlarının iyileştirilmesinde etkili ve güvenlidir; ancak, inhale kortikosteroid tedavisi yokluğunda LABA monoterapisi hiçbir şekilde uygulanmamalıdır. Uygun dozlarda inhale kortikosteroid kullanımına rağmen kurtarma tedavisine gereksinim duyan astım hastalarının tedavi rejimlerine düzenli bronkodilatör eklenmelidir.
Current guidelines recommend inhaled steroids as the first line control medication in the treatment of asthma. However, many patients particularly with airway obstruction need bronchodilators either as a symptom reliever or control medication to provide relaxation of bronchiolar smooth muscles. Both short acting and long acting beta-2 agonists (SABA and LABA) are of particular importance among the bronchodilators used in asthma. Despite their well-known benefits, in the recent years, a growing body of publications has been published on the safety of LABAs. However, the increased risk reported to be related to LABA monotherapy was not observed in patients receiving inhaled corticosteroid as the standard treatment in combination with LABA. the benefits of adding LABAs to inhaled corticosteroid have been thoroughly documented, while the risks, including asthma mortality, are currently under debate. Pharmacogenetic advancements drew attention to a potential genetic explanation for certain side effects of these medications whose efficacy and safety have been proven in several studies. in conclusion, LABAs are effective in relieving symptoms and improving lung functions and safe when combined with inhaled corticosteroid in asthma; however, LABA monotherapy should never be administered in the absence of inhaled corticosteroid treatment. Asthma patients that lack control of disease despite adequate doses of inhaled corticosteroids need addition of a regular bronchodilator to their treatment regimen.
Current guidelines recommend inhaled steroids as the first line control medication in the treatment of asthma. However, many patients particularly with airway obstruction need bronchodilators either as a symptom reliever or control medication to provide relaxation of bronchiolar smooth muscles. Both short acting and long acting beta-2 agonists (SABA and LABA) are of particular importance among the bronchodilators used in asthma. Despite their well-known benefits, in the recent years, a growing body of publications has been published on the safety of LABAs. However, the increased risk reported to be related to LABA monotherapy was not observed in patients receiving inhaled corticosteroid as the standard treatment in combination with LABA. the benefits of adding LABAs to inhaled corticosteroid have been thoroughly documented, while the risks, including asthma mortality, are currently under debate. Pharmacogenetic advancements drew attention to a potential genetic explanation for certain side effects of these medications whose efficacy and safety have been proven in several studies. in conclusion, LABAs are effective in relieving symptoms and improving lung functions and safe when combined with inhaled corticosteroid in asthma; however, LABA monotherapy should never be administered in the absence of inhaled corticosteroid treatment. Asthma patients that lack control of disease despite adequate doses of inhaled corticosteroids need addition of a regular bronchodilator to their treatment regimen.
Açıklama
Anahtar Kelimeler
Kulak, Burun, Boğaz, Solunum Sistemi
Kaynak
Tüberküloz ve Toraks
WoS Q Değeri
Scopus Q Değeri
Cilt
59
Sayı
2
