title: Recent trends and directions in the rationalization of pharmacotherapy of bronchial asthma: probing for alternatives.
abstract: Although tremendous progress has been made in the understanding of Bronchial Asthma (BA) over the past decade, asthma remains a frequently encountered challenging condition for the physicians in the health care locale. Inflammation is distinguished as the most important event in the pathogenesis and the knowledge that asthma is an inflammatory disorder has become elementary to our explanation of asthma; this has broadened the perspective for the treatment of BA. However, bronchodilators and corticosteroids are still the mainstay of asthma treatment over the decades. The introduction of superior derivatives of corticosteroids and beta agonists, the choice, safety, duration of action and ease of delivery have enhanced progressively. Surrogated anti-inflammatory agents have been used in severe disease, but have been limited by adverse effects. The introduction of new agents affecting leukotrienes synthesis and action provides an alternative strategy but it needs to be confirmed on a large subset of population of asthmatics. In fact, the past decade has been witnessed by a proliferation of scientific information and a widespread addition of anti-inflammatory therapy to improve asthma outcomes along with the recommended therapies. In this context, there has been much advancement in the available pharmacologic panorama for both chronic and acute therapy and the development and approval of novel medications. Yet, many controversies abound this disorder, and further fundamental developments in novel therapeutics are imminent. This review of asthma for the practicing clinician will summarize these developments and their implications in treatment of BA.
authors.affiliation: Department of Pharmacology, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal. bpdas2000@yahoo.com
authors.forename: B P
authors.initials: BP
authors.lastname: Das
authors.forename: A
authors.initials: A
authors.lastname: Sethi
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D018579:Patient Selection; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists; D007155:Immunologic Factors; D020024:Leukotriene Antagonists