支气管哮喘治疗新药开发

虽然甘前的抗炎药物和支气管扩张剂等药物对多数支气管哮喘有效,但仍存在不能控制的支气管哮喘病例和一定的不良反应.国外研究显示,新的药物包括新的支气管扩张剂和抗炎新药,将更好地治疗哮喘,减少不良反应,增加患者依从性.本文就新开发的可能应用于临床支气管哮喘治疗的新药做一综述.     

支气管哮喘治疗新药物的研究进展

支气管哮喘是临床十分难治的一种疾病,且在临床十分常见,据临床调查显示,全世界每年约5千万人患有哮喘疾病,且发生率和严重程度正呈逐渐上升趋势。此疾病的临床治疗关键在于,使用支气管扩张剂对急性症状进行短期治疗,使用抗炎药物药物预防且逆转慢性炎症。以往临床治疗中多采用吸入皮质甾体。其不但能够降低支气管的超敏作用,并能够进一步改善患者的肺部功能,减轻临床症状,提高生活质量。但是,在使用此药物时也会产生一定的不良反应,并且不能治愈哮喘。因此,使用新药物给予支气管哮喘患者更好的治疗是临床的关键。本研究综述了支气管哮喘治疗的新药物,包括阿福特罗、糠酸莫米松、罗氟司特、西洛司特、环索奈德几种新药。     

异搏定治疗支气管哮喘临床疗效观察

支气管哮喘是我国目前的一种常见病、多发病。近年来,对其发病机理与治疗不断探索,对平喘新药进行了大量的临床验证,力图取得满意疗效,寻找支气管哮喘治疗的     

支气管哮喘治疗新药物的研究进展

支气管哮喘是临床十分难治的一种疾病,且在临床十分常见,据临床调查显示,全世界每年约5千万人患有哮喘疾病,且发生率和严重程度正呈逐渐上升趋势.此疾病的临床治疗关键在于,使用支气管扩张剂对急性症状进行短期治疗,使用抗炎药物药物预防且逆转慢性炎症.以往临床治疗中多采用吸入皮质甾体.其不但能够降低支气管的超敏作用,并能够进一步改善患者的肺部功能,减轻临床症状,提高生活质量.但是,在使用此药物时也会产生一定的不良反应,并且不能治愈哮喘.因此,使用新药物给予支气管哮喘患者更好的治疗是临床的关键.本研究综述了支气管哮喘治疗的新药物,包括阿福特罗、糠酸莫米松、罗氟司特、西洛司特、环索奈德几种新药.     

支气管哮喘患者急性发作临床治疗的药学监护及其体会

目的:探究支气管哮喘患者急性发作临床治疗的药学监护,为临床合理用药提供参考。方法:临床药师参与支气管哮喘患者急性发作病原菌的检测分析和临床用药监护过程,评价了其药物治疗的合理性。结果:正确的预防和控制感染,长期的规范化治疗,患者病情的自我监测和管理是治疗支气管哮喘的有效方法。结论:临床药师根据支气管哮喘患者的临床治疗实际情况,建立有针对性的药物治疗方案,提高支气管哮喘患者用药的合理性及临床治疗有效性。     

支气管哮喘白三烯代谢与孟鲁司特抗白三烯治疗的临床分析

目的应用孟鲁司特对患有支气管哮喘的患者实施治疗的临床效果进行研究。方法抽取74例患有支气管哮喘的患者,随机分为对照组和治疗组,平均每组37例。采用糖皮质激素类药物对对照组患者实施治疗;采用糖皮质激素与孟鲁司特联合对治疗组患者实施治疗。结果治疗组患者支气管哮喘病情治疗效果明显优于对照组;哮喘症状消失时间和用药治疗时间明显短于对照组。结论应用孟鲁司特对患有支气管哮喘的患者实施治疗的临床效果非常明显。     

分析他汀类药物治疗支气管哮喘的疗效

目的探讨他汀类药物治疗支气管哮喘的疗效。方法对我院2012年2月至2013年1月收治的支气管哮喘患者临床治疗病例进行抽样,将40例支气管哮喘患者病例按照抽签法随机分为对照组与治疗组,每组20例。对照组采用茶碱缓释片口服治疗,观察组采用他汀类药物治疗。观察两组患者疗效及患者满意度。结果两组支气管哮喘患者经过治疗之后,对照组治疗总有效率为55.00%,患者满意度为60.00%;观察组治疗总有效率为95.00%,患者满意度为100%。两组支气管哮喘患者临床治疗效果具有显著差异性,具备统计学意义(P<0.05)。结论支气管哮喘患者采用他汀类药物治疗的临床疗效明显优于口服茶碱缓释片治疗的临床疗效,能够明显控制患者支气管哮喘的程度,值得进行临床推广应用。     

支气管哮喘住院患者的药学监护及合理用药

目的对支气管哮喘住院患者的药学监护及合理用药进行探讨。方法随机抽取我院在2013年8月治疗的1例支气管哮喘住院患者,根据哮喘最新治疗指南,根据支气管哮喘住院患者的实际情况来制定有针对性的药学监护,并对哮喘治疗用药的合理性进行分析。结果患者在治疗过程中使用的多种药物,例如特布他林、头孢唑肟、二羟丙茶碱以及茶碱缓释片等,患者的病情得到有效控制。结论临床药师根据支气管哮喘患者的临床治疗实际情况,建立有针对性的药学监护,对患者的用药实施全程监控,以提高支气管哮喘患者治疗过程中用药的合理性,提高支气管哮喘患者的临床治疗效果。     

支气管哮喘患者37例临床分析

目的研究分析支气管哮喘患者的临床资料,提高临床诊断治疗支气管哮喘水平。方法选取我院于2006年4月至2013年1月收治的37例支气管哮喘患者,对其临床资料进行分析研究。结果 37例哮喘患者接受治疗后,其中12例轻度支气管哮喘患者,治疗总有效率为94.1%;14例中度哮喘患者中,治疗总有效率为92.1%;11例重度哮喘患者中,治疗总有效率为87.5%。结论支气管哮喘患者的临床症状表现并不明显,多合并一些基础病症,病情较为复杂,且病史长,对患者生命健康造成严重的威胁,因此,在临床治疗中,应注意对其进行有效的诊断以及治疗,有效提高临床诊治水平。     

1例老年支气管哮喘患者的药学监护

目的探讨临床药师为老年支气管哮喘患者实施药学监护,以改善治疗效果。方法通过参与临床查房,在工作实践中不断检验和完善对老年支气管哮喘患者实施药学监护的途径。结果通过实施药学监护,可明显提高老年支气管哮喘患者预防和用药的安全性,有效性和经济性。结论临床药师应在临床工作中不断总结和探索,对老年支气管哮喘进行最合理的药物治疗。     

Trends in pharmacogenomics of drugs used in the treatment of asthma.

Pharmacogenetic studies of drugs used in the treatment of asthma have produced a few examples of reduced response in patients carrying specific genotypes in genes involved in the action of beta-2 agonists or leukotriene modifiers. Other candidate genes related to these drugs, as well as glucocorticoids, theophilline, anticholinergics, antihistaminics, and drug-metabolizing enzymes, may be proposed. Statistical power and population stratification may be issues of importance in case-control association studies. Future developments include expanded gene knowledge from asthma genetic and genomic studies, the development of new preventive and curative treatments, multiple contemporary genotyping methods for pharmacogenetically important genes in a given individual, and the construction of asthma functional pharmacogenomic profiles. In conclusion, it seems that asthma pharmacogenetic studies need to be replicated in prospective clinical trials in different populations with a large number of subjects being genotyped. It is suggested that large clinical trials which are proposed for asthma drugs experimentation should include a pharmacogenetic study as well.     

The increasing challenge of discovering asthma drugs

The prevalence of asthma continues to rise. Current drugs provide symptomatic relief to some, but not all, patients. Despite the need for new therapeutics, and a huge research effort, only four novel agents from two classes of drugs – the antileukotrienes and an anti-IgE antibody – have been approved in the last 30 years. This review highlights three particular issues that contribute to the challenge of identifying new therapeutics. First is an over-reliance on animal models of allergy to define targets and expectations of efficacy that has met with poor translation to the clinical setting. While sensitivity to particular aeroallergens is one key risk factor for asthma, atopy and asthma are not synonymous, and while about half of adult asthmatics are atopic the incidence of allergic asthma is probably <50%. The second issue is a fundamental disconnect between the directions of basic research and clinical research. Basic research has developed a detailed, reductive, unifying mechanism of antigen-induced, T helper type 2 cell-mediated airway inflammation as the root cause of asthma. In contrast, clinical research has started to identify multiple asthma phenotypes with differing cellular components, mediators and sensitivities to asthma drugs, and probably varying underlying factors including susceptibility genes. Finally, different features of asthma – bronchoconstriction, symptoms, and exacerbations – respond diversely to treatment; effects that are not captured in animal models which do not develop asthma per se, but utilize unvalidated surrogate markers. Basic research needs to better integrate and utilize the clinical research findings to improve its relevance to drug discovery efforts.     

An update of the leukotriene modulators for the treatment of asthma

Bronchial asthma is a chronic inflammatory airway disease involving many cells and mediators. Chronic inflammation constitutes an important predisposing condition for airway remodelling with secondary irreversible airflow obstruction. Current approaches for asthma treatment involve many classes of drugs, adequate patient education for their correct use, environmental exposure control and daily monitoring of pulmonary function. Unfortunately, the use of multiple therapies complicates treatment regimens, thus leading to a reduced compliance to therapy. Available evidence from randomised clinical trials and real-word experience derived from managing patients with asthma justifies a broader role for leukotriene receptor antagonist drugs in asthma management than that recommended in the National Asthma Education and Prevention Programme and National Health Lung and Blood Institute Treatment Guidelines. While a low dose of inhaled corticosteroids remains the reference drug as a controller in mild-to-moderate persistent asthma, oral therapy with an leukotriene-receptor antagonist drug represents a good option providing the clinical efficacy requested in common clinical practice. For this reason the recent Global Initiative for Asthma Guidelines allocate this drug to the second and third steps of asthma treatment.     

An update of the leukotriene modulators for the treatment of asthma

Bronchial asthma is a chronic inflammatory airway disease involving many cells and mediators. Chronic inflammation constitutes an important predisposing condition for airway remodelling with secondary irreversible airflow obstruction. Current approaches for asthma treatment involve many classes of drugs, adequate patient education for their correct use, environmental exposure control and daily monitoring of pulmonary function. Unfortunately, the use of multiple therapies complicates treatment regimens, thus leading to a reduced compliance to therapy. Available evidence from randomised clinical trials and real-word experience derived from managing patients with asthma justifies a broader role for leukotriene receptor antagonist drugs in asthma management than that recommended in the National Asthma Education and Prevention Programme and National Health Lung and Blood Institute Treatment Guidelines. While a low dose of inhaled corticosteroids remains the reference drug as a controller in mild-to-moderate persistent asthma, oral therapy with an leukotriene-receptor antagonist drug represents a good option providing the clinical efficacy requested in common clinical practice. For this reason the recent Global Initiative for Asthma Guidelines allocate this drug to the second and third steps of asthma treatment.     

Targeting Th2 cells in asthmatic airways

The most effective anti-asthmatic drugs currently available include inhaled beta2-agonists and glucocorticoids and control asthma in about 95% of patients. The current asthma therapies are not cures and symptoms return soon after the treatment is stopped even after long-term therapy. In addition, severe glucocorticoid-dependent and -resistant asthma still represents a great clinical burden accounting for approximately 50% of the health care costs of asthma and reducing the side-effects of glucocorticoids using novel dissociated steroids, soft steroids or with steroid-sparing agents will prove beneficial. Furthermore, the mechanisms involved in the persistence of inflammation are poorly understood and the reasons why some patients have severe life threatening asthma and others have very mild disease are still unknown. Hopefully, it will soon be possible to identify and manipulate the molecular switches that result in asthmatic inflammation. This may lead to the treatment of susceptible individuals at birth or in the early years and thus prevent the disease from becoming established. Drug development for asthma has been directed at improving currently available drugs and finding new compounds that usually target the Th2-driven airway inflammatory response. Several new drugs have been developed to target specific components of the Th2-driven inflammatory process in asthma (e.g. IgE antibodies, cytokines and/or chemokines, immunomodulators, antagonists of adhesion molecules), although they have not yet been proven to be particularly effective. Some of these new Th2-oriented strategies may in the future not only control symptoms, but also potentially prevent or cure the disease.     

Asthma. Bronchodilators: new developments.

This chapter is concerned with recent controversies and new developments in the area of established bronchodilators, namely beta-agonists, antimuscarinic drugs and methylxanthines. It focuses on the studies concerned with fenoterol and its possible role in asthma deaths in New Zealand, the new long-acting beta-agonists and the place of beta-agonists in the treatment of asthma. The possible reasons for the fact that antimuscarinic drugs have been less effective in general than beta-agonists in asthma are explored and the difficulties of using theophylline in clinical practice and its role in the treatment of asthma are discussed.     

白三烯抑制剂在哮喘治疗中的进展

目的：介绍白三烯抑制剂治疗哮喘的进展。方法：综述近年来国外有关文献,介绍和评价白三烯抑制剂的临床疗效,不良反应和用法用量。结果：白三烯抑制剂有效地治疗哮喘发作,且副作用较少。结论：白三烯抑制剂临床使用安全有效,是一类新的哮喘治疗药物。     

孕妇哮喘防治中的误区与对策

目的观察妊娠期哮喘治疗效果及安全性。方法将我院(2009年1月1日至2012年1月1日)明确诊断的64例孕妇哮喘急性发作期患者,予以抗炎、解痉、平喘、祛痰等治疗后,观察治疗前、后的临床症状评分、肺功能指标(FEV1、FEV1占预计值的%)及药物不良反应。结果孕妇哮喘症状得到控制,胎儿未发生宫内缺氧。结论治疗哮喘的大多数药物对胎儿是比较安全的,而未控制的哮喘的风险远远高于哮喘治疗药物对妊娠造成的风险。     

Drug therapy in asthma bronchiale in the new millennium

Asthma bronchiale represents a major health issue in industrialized countries and will likely remain so for decades. The drug treatment of asthma demonstrates certain peculiarities: revolutionary new drug introductions happen almost each quarter century. With improved understanding of asthma pathogenesis and drug metabolism, the potential for specific targeted and constructed therapies has become evident. Monoclonal antibodies to IgE and certain cytokines such IL-4 and IL-5 are being investigated as possible treatments for asthma. Similarly, preliminary studies of selective phosphodiesterase inhibitors in asthmatic patients have been encouraging. Other potential therapies include for example inhibitors of cytokine synthesis, promoters of Th2-Th1 switch, adenosine receptor agonists or antagonists, etc.. A new way is represented by a modified retrometabolic drug design resulting in so-called soft drugs. The first representative of this new drug class is loteprednol etabote (LE), a non-fluorinated glucocorticoid approved for the allergic ophthalmological indications and now in clinical trial for the treatment of allergic airway diseases. Today's intensive search for new treatments should ensure a greater diversity of therapeutic possibilities for the management of asthma in the new millennium.