The causative agent of asthma are aspirin nonsteroidal anti-inflammatory drugs, contributing to narrowing bronhov.K NSAIDs include aspirin, or acetylsalicylic acid, which is used as an analgesic, anti-inflammatory agent. It is often combined with aspirin asthma, infectious asthma (9-22% of patients suffer from two kinds of asthma) but it can exist in pure form.
Aspirin asthma is not innate and acquired disease.
Symptoms of asthma aspirin mainly manifested after undergoing atopic asthma, so it does not get sick children. In most cases sick women aged 30-50 years.
Symptoms of a severe nasal congestion and rhinitis, and as a consequence, reduction of smell and headache. Further, in the nose and sinus polyps appear and should begin asthma and intolerance to NSAIDs.
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The mechanism of aspirin-induced asthma
The reason is the interference of aspirin in the metabolism of arachidonic acid, which is contained in the cell membrane. In a healthy state, this acid by the enzyme cyclooxygenase converted into a compound which enhances the inflammatory reaction run. And in this situation, NSAIDs inhibit the enzyme, not allowing it to develop. In patients with aspirin asthma cyclooxygenase enzyme is defective, and the body uses another lipoxygenase, which converts arachidonic acid to leukotrienes, contributing to edema of the bronchi, the development of sputum. As a result, they begin to show symptoms of aspirin-induced asthma.
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From what abstain from aspirin asthma?
The patient should not take the drug pirazolonovogo series: Teofedrin, analgin, spazmalgon, baralgin, aminopyrine, tempalgin, reopirin, aspirin and other NSAIDs, and the means to which they belong: diclofenac, indomethacin, ibuprofen, sulindac, piroxicam, naproxen, etc. .d.
If necessary, and as a bole- zharoutolyayuschee can take paracetamol solpadein, tramadol (or Tramal), phenacetin.
Along with the listed drugs, aspirin-induced asthma can be manifested by the presence of a food dye tartrazine yellow (as in food and in the preparations). The chemical composition of it is similar to aspirin.
Patients can not eat bakery products and alcoholic beverages yellow (contains tartrazine).
Harmful and salicylates: natural (tomatoes, raspberries, oranges, black currants, plums, cucumbers, apricots, cherries), industrial (canned food and gastronomy). Natural salicylates contain tartrazine in small quantities, so rarely cause an attack. Generation of histamine dangerous for the patient, this process provoke citrus, fish, fresh cabbage.
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Take urgent measures
Sometimes a person is unaware of the presence of the disease at home and taking aspirin. When the first symptoms appear (in 5-10 minutes begins runny nose, cough, difficulty breathing), you must:
wash out the stomach: drink 1 liter of boiled water, and then click on the root of the tongue to clean the stomach. If you popped a tablet, then the next action is required;
drink 10 tablets of activated charcoal and an antihistamine tablet series (tavegil, suprastin, Claritin, etc.);
when the attack is over, you need to make an appointment with a doctor, allergist.
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How to identify aspirin-induced asthma?
To identify aspirin asthma may be carried out special tests in vivo. Under the supervision of an allergist with special equipment (in case of an attack) the patient is given an aspirin (or other drug related to NSAIDs). A test was conducted in which 100 people participated: one-third of subjects with aspirin asthma symptoms were absent from the second third of bronchospasm observed that sometimes not fixed by clinically, and only the remaining one-third was observed severe reaction to the drug.
Tests are conducted in vitro, but in this case there is no risk of attack, as Research conducted on the reaction with blood cells (primarily to deliver the blood).
The response to NSAIDs may occur anywhere in the respiratory system, and in some cases may be affected intestine, stomach, and other mucous membranes. Negatively it affects the immune system, which is manifested in the form of strong and prolonged inflammatory diseases.
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Desensitization is the main method of treatment
Desensitization - this is one way of treating asthma aspirin based, as in vivo tests, provoked, only small doses over time. Treatment must necessarily be carried out in a clinic under the supervision of specialists with all necessary equipment. For example, every 30 minutes the patient is given a drug with a constant increase of aspirin doses: 3, 30, 60, 100, 150, 325 and 650 mg. But this rapid method is quite hard, which basically ends with asthma attacks. Therefore, an increase in dose is best done in a day.
Before desensitization is necessary to remove the aggravation of asthma and check for contraindications, which are: pregnancy, bleeding, stomach ulcers and duodenal ulcers.
Inhalations, not only as a basic method, but in the case of duodenal ulcer or stomach (in this case, you can use the injections and aspirin-lysine). Very easy to use aldetsin (USA), as it has a removable nasal packing, which is very important when polypoid rhinosinusopathy.
Surgical intervention is even more complicated and developed symptoms of the disease.
If the patient does not tolerate desensitization, hemosorbtion held during the week and again desensitization. If the symptoms are manifestations of the disease are weak, then hemosorbtion able to completely cure the patient suffering from aspirin-induced asthma.
After recovering in hospital the patient is assigned to support outpatient treatment, which essentially consists of taking aspirin regularly for a year after eating, drinking alkaline mineral water, under strict medical supervision.
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Leukotriene Antagonists
Treatment antileukotriene drugs - a treatment antagonists (from the Greek. Translates as "the enemy") leukotrienes. But along with inhaled hormonal agents, it is recommended to use and tableted.
About 20 years ago, many companies engaged in the development antileukotrienes in two directions: inhibitors (substances that suppress any reaction) leukotriene synthesis and agents that bind to leukotriene receptor (such as antihistamines). It was synthesized by a huge number of connections, but only four of them are active: zileuton (first line); zafirlukast, montelukast and pranlukast (the second direction). But as it turns out in practice, aspirin asthma can not be cured completely, but reduced the number of additional products and the number of attacks.
Leukotriene drugs are still in development. They belong to a group of drugs that contribute to controlling asthma and aspirin are associated in the treatment of patients.
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Hemosorption and laser irradiation of blood
The complex and heavy aspirin-induced asthma is treated by a combination of hemosorption and intravenous laser irradiation of blood.
Hemosorption essence is to remove the body of toxic substances, or through the influence of pathological sorbent outside the body.
Laser irradiation of blood (fotogemoterapiya, intravascular laser irradiation of blood, VLOK) - method of efferent therapy (extracorporeal detoxification, gravitational blood surgery), which is low-energy lasers dosage effects.
Method VLOK processes affect the subcellular and cellular levels, so restoring the normal functioning of tissues and organs. It is important that no foreign substances are introduced into the body to act on any individual element of the disease, but only adjusted organism self-regulation. Therefore, this method is very efficient, versatile and safe.
VLOK done every day (or every other day), the rate is determined by a doctor, and an average of 3 to 10 procedures. Treatment time - 15-20 minutes. Laser irradiation of blood painlessly.
