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Jiří Slíva M.D.
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Absolute number of patients suffering from AB in Czech. Rep. Period Number of patients
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THE MOST IMPORTANT ALERGENES
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JANUARY FEBRUARY MARCH APRIL MAY 1. DEC. 2. DEC. 3. DEC. Pollen situation of„Alnus glutinosa“ in the Europe
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DIAGNOSIS 1. ANAMNESIS 3. LABORATORY TESTS 2. CLINICAL FEATURES 4. ALLERGOLOGICAL TESTS
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own pharmacoterapy life style specific imunotherapy symptomatic antiinflammatoric preventive
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sympatomimetics anticholinergics corticosteroides methylxantines antileucotriens antihistamines Groups of drugs:
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β-mimetics - nonselective - adrenaline, isoproterenol, orciprenaline, ephedrine - selective - metaproterenol, albuterol, salbutamol, terbutalin, fenoterol => more effective via inhalation then per os administration => increase of cAMP Parasympatolytics ipratropium Antiasthmatics with rapid effect:
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theophylline - myotropic influence via inhibition of phosphodiesterase and via influence on the adenosine receptors A 2 => bronchodilatation => prevention from bronchoconstriction caused by histamine, cholinergic agonists (metacholine) or exertion. Aminophylline = theophylline + ethylendiamine Methylxantines :
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inhibition of degranulation of mastocytes after exposition to specific agents full effect after 4-6 weeks Drugs used for prevention and maintained treatment: cromoglycate sodium nedocromil similar to cromoglycate in mechanism of action
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β 2 -mimetics with long-term effect: via inhalation salmeterol and formoterol via per os ( tabl, sirup) klenbuterol, prokaterol, salbutamol Teophylline with prolonged releasing
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zafirlukast zileuton montelukast Antileucotriens = Leucotriene Receptor Antagonists (LTRAs):
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beklometasone budesonide flunisolide fluticasone triamcinolone potent antiinflammatory effect decrease of number of inflammatory potent cells inhibition of bronchoconstrictory mechanisms direct relaxation of smooth muscle cells Corticosteroids:
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astemizole (Hismanal) clemastine terphenadine ketotifen (Zaditen) reversible competitive antagonists of H-receptors Antihistamines:
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verapamile (Isoptin) nifedipine others inhibition of calcium influx => inhibition of contraction of smooth muscle cells induction of bronchodilatation used experimentaly Inhibitors of calcium channels:
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Comparison of numbers of drugs used in therapy of bronchial asthma
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