女性支气管哮喘_培训课件.ppt

Leukotriene receptor antagonists may be considered as an alternative to increased doses of inhaled steroids as add-on therapy to glucocorticosteroids (Level II) There is insufficient data to recommend LTRAs for regular therapy in place of inhaled glucocorticosteroids (Level IV) Cromoglycate should not be added to an established regimen of inhaled / systemic steroids (Level I) may be used as a less effective alternative to short-acting ?2-agonists to prevent exercise-induced symptoms (Level I) may be an alternative to low-dose IHS in children with mild symptoms (Level I) unwilling to take inhaled glucocorticosteroids may be used for short-term allergen exposure (Level I) Nedocromil is not recommended for first line therapy of asthma may be considered as a less effective alternative to short-acting ?2-agonists to prevent exercise-induced bronchospasm (Level I) may be a modestly effective alternative to low-dose inhaled glucocorticosteroids in children with mild symptoms (Level I) Theophylline not recommended as 1st-line therapy (Level I) may be used as an alternative to increased doses of inhaled glucocorticosteroids (Level II) dose must be titrated slowly (Level III) because of the narrow therapeutic range and the potential for severe side effects Anticholinergic bronchodilators not recommended as 1st-line therapy except in patients who cannot tolerate ?2-agonists (Level III) long-acting inhaled ?2-agonists  (salmeterol,formoterol) These work in the same way as the ordinary relievers such as salbutamol and terbutaline, with the difference that they stick to the cells in the body on which they act, and so work for much longer. The side-effects are the same, namely tremor, increased pulse rate, and palpitations ,They have been introduced much more recently, but no hazards in pregnancy are known. Other therapies in chronic severe asthma unresponsive to moderate doses of oral glucocorticosteroids confounding factors should be assessed before increasing therapy pa