Oral montelukast at 10 mg per day in addition to the standard treatment is helpful in individuals admitted with acute asthma exacerbation. When added to the standard regimen of acute asthma montelukast improves the peak expiratory flow rate on the morning after admission.
Asthma affects approximately 300 million individuals worldwide. Asthma is characterized by reversible airflow obstruction, airway hyperreactivity and airway inflammation. Asthmatics suffer from periodic acute exacerbations of their disease activity possibly triggered by viral infections and a variety of other causes. The standard therapy for acute exacerbations of asthma includes systemic steroids and inhaled bronchodilators/ corticosteroids.
Montelukast belongs to a class of drugs called as leukotriene receptor antagonists. Leukotrienes are molecules generated during the inflammatory process by eosinophils and mast cells present in the human tissue. These leukotrienes are potent airway constrictors. They also cause airway edema and increased mucous production. Montelukast by blocking the action of leukotrienes prevents airflow obstruction and generally helps in airway clearance.
Montelukast is currently recommended as a secondary agent after inhaled steroids in the management of chronic stable asthma. Montelukast is generally safe and well tolerated. It also reduces the amount of steroids needed for controlling asthma. Steroids are known to cause several adverse effects. Some studies have shown that the medication compliance is better with oral montelukast than the inhaled steroids. The role of montelukast in acute asthma was evaluated in smaller studies and found to be beneficial.
In a recent study published in Thorax, a journal of respiratory medicine the usefulness of montelukast in the treatment of acute asthma was studied in Norwich University Hospital, UK. The study found that the use of montelukast as an add-on drug to the standard acute asthma treatment protocol improved the peak expiratory flow rate in the morning after admission. Peak expiratory flow rate is one of the standard tools to measure the severity of asthma attack and the subsequent progress.
Reference
Thorax 2011;66:7-11 doi:10.1136/thx.2010.135038
http://thorax.bmj.com/content/66/1/7.short
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