Abstract:Regular anti-inflammatory treatment is essential in treating persistent asthma. Most commonly, inhaled corticosteroids (ICS) are used. However, especially in children, there is concern about the long-term safety of ICS such that doses should be kept to a minimum. The use of theophylline has decreased because of frequent side-effects in therapeutic doses. In adults, there have been reports about an immunomodulatory effect of low-dose theophylline. To study the clinical and immunomodulatory effect in children, 3… Show more
“…Theophylline, although effective is considered as the third-line therapy in the treatment of bronchial asthma due to the drug's frequent side effects. The low-dose of theophylline in moderate childhood asthma is safe and well tolerated (Suessmuth, 2003). At low doses, the drug is easier to use, side effects are uncommon and the problems of drug interaction are less of an issue, thus making the clinical use of theophylline less complicated.…”
Research in the area of respiratory pharmacology and toxicologyis very exciting and vital for the development of new drugs with more efficacy and safety. Several medicinal plants from the Ayurveda and Unani systems of medicine are being evaluated for their efficacy and safety by using modern medical techniques;with an aim to bring them to the mainstream of the health care system. Effects of yogic intervention on pulmonary functions, cellular and molecular markers and quality of life in patients of bronchial asthma are also being assessed. Further, a lot of work is also going on novel aspects of immunotherapy and nanomedicine in the management of respiratory disorders. This review also highlights the relevance and pharmacoeconomic impact of nutraceuticals in prevention and treatment of respiratory diseases. Many clinical trials are being conducted to compare the efficacy and safety of already marketed individual drugs and combination therapy. Pharmacovigilance studies are being conducted to monitor the ADRs during pharmacotherapy of respiratory diseases, assess the causal relationship and find ways to prevent the ADRs to rationalize the therapy. However, more translational research is needed to bring scientific advances and knowledge into clinical practice; and there is a great need to find effective ways for collaboration between various research disciplines. There should be a focus on earlier and more specific diagnosis of respiratory diseases as well as better targeted and personalized treatments which may save cost, reduce adverse effects and improve disease outcomes and quality of life.
“…Theophylline, although effective is considered as the third-line therapy in the treatment of bronchial asthma due to the drug's frequent side effects. The low-dose of theophylline in moderate childhood asthma is safe and well tolerated (Suessmuth, 2003). At low doses, the drug is easier to use, side effects are uncommon and the problems of drug interaction are less of an issue, thus making the clinical use of theophylline less complicated.…”
Research in the area of respiratory pharmacology and toxicologyis very exciting and vital for the development of new drugs with more efficacy and safety. Several medicinal plants from the Ayurveda and Unani systems of medicine are being evaluated for their efficacy and safety by using modern medical techniques;with an aim to bring them to the mainstream of the health care system. Effects of yogic intervention on pulmonary functions, cellular and molecular markers and quality of life in patients of bronchial asthma are also being assessed. Further, a lot of work is also going on novel aspects of immunotherapy and nanomedicine in the management of respiratory disorders. This review also highlights the relevance and pharmacoeconomic impact of nutraceuticals in prevention and treatment of respiratory diseases. Many clinical trials are being conducted to compare the efficacy and safety of already marketed individual drugs and combination therapy. Pharmacovigilance studies are being conducted to monitor the ADRs during pharmacotherapy of respiratory diseases, assess the causal relationship and find ways to prevent the ADRs to rationalize the therapy. However, more translational research is needed to bring scientific advances and knowledge into clinical practice; and there is a great need to find effective ways for collaboration between various research disciplines. There should be a focus on earlier and more specific diagnosis of respiratory diseases as well as better targeted and personalized treatments which may save cost, reduce adverse effects and improve disease outcomes and quality of life.
“…70, 71 One small trial showed that the addition of theophylline to inhaled corticosteroids resulted in improvement in peak expiratory flow, but did not improve FEV1 or bronchial reactivity. 72 Given the lack of substantial supporting evidence, potential toxicity, and need for frequent monitoring, theophylline is not part of first-line therapy for children with asthma and is not recommended for children under 5. 5 …”
Section: Alternatives To Inhaled Corticosteroidsmentioning
Synopsis
Over the past several decades, the evidence supporting rational pediatric asthma management has grown exponentially. As more is learned about the various phenotypes of asthma, the complexity of management will continue to grow. This review focuses on the evidence supporting the current guidelines-based pediatric asthma management and explores the future of asthma management with respect to phenotypic heterogeneity and biologics.
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