The expanding role of leukotriene receptor antagonists in chronic asthma
To provide a comprehensive review of studies that evaluate the effects of leukotriene receptor antagonists in adult chronic asthma.
A literature search using MEDLINE, Clinical Evidence, and the Cochrane Library was performed using the following keywords: randomized controlled trial, asthma, cysteinyl leukotriene, leukotriene receptor antagonist, antileukotriene, montelukast, zafirlukast, pranlukast, inflammation, lung function, exacerbations, and symptoms.
Relevant peer-reviewed articles (mostly randomized controlled trials, meta-analyses, and reviews) published up to July 2006 were selected and extracted.
Leukotriene receptor antagonists are beneficial across a range of asthma severities and may have a particular role in exercise-induced asthma, aspirin-sensitive asthma, and individuals with concomitant allergic rhinitis.
In the management of chronic asthma, leukotriene receptor antagonists have emerged as a useful oral nonsteroidal anti-inflammatory adjunct both as monotherapy and in combination with other classes of drugs. Monitoring their effects in terms of lung function alone may result in clinicians missing beneficial effects on inflammatory biomarkers, airway hyperresponsiveness, and exacerbations.
Available from: Ahmed Ibrahim Badr Eldin
- "It is used as the sodium salt, but doses are expressed in terms of the base; montelukast sodium 10.38 mg is equivalent to about 10 mg of montelukast. In the management of chronic asthma (Currie and McLaughlin 2006) and as prophylaxis for exercise-induced asthma, montelukast sodium is given in doses equivalent to 10 mg of montelukast once daily in the evening. It should not be used to treat an acute asthma attack. "
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ABSTRACT: Simple, sensitive and accurate stability indicating analytical method for montelukast has been developed and validated by using RP-HPLC techniques and applying the proposed method in the assay of Montelukast ® tablets (SIGMA Pharmaceuticals), since there is no official monograph. The procedure was developed and validated under acidic, basic, oxidative and photo-irradiation conditions. Chromatography was performed with mobile phase containing a mixture of acetonitrile and 0.01M potassium dihydrogen phosphate buffer pH 4.0 (7:3 v/v) with flow rate of 1.0 mL per min, C 18 column and UV detection at 355 nm. developed method satisfies the system suitability criteria, peak integrity, and resolution for the parent drug and its degradants. The method was validated for linearity (correlation coefficient = 0.9999), accuracy, and precision. Experimental design was used for validation of robustness and intermediate precision. The proposed method was simple, highly sensitive, precise and accurate. And the run time was less than 15 min which indicates the method is useful for routine quality control analysis and stability testing. Montelukast was determined to be more sensitive to the acidic conditions and photodegradation on light exposure, oxidation may also appear. But it was stable in alkaline medium.
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ABSTRACT: The principal components of the asthmatic response are airways hyper-responsiveness, persistent inflammation and mucus hypersecretion. Although these components are inter-related, any of these can predominate at different times and for different patients and each requires a different approach to therapy. As a result of the inflammation and epithelial damage, there can be abnormal repair mechanisms leading to fixed airflow obstruction that has been termed 'airways remodeling'. Although there are a number of highly effective therapeutic agents used to treat asthma today, novel therapies are being designed to more specifically and safely target these different components and better meet the needs of patients with asthma.
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