Describe the impact of asthma (e.g., morbidity, mortality, economic impact, grou

Question

Describe the impact of asthma (e.g., morbidity, mortality, economic impact, groups disproportionately affected) on the U.S. population.

- What is the mechanism of action of albuterol? What is the mechanism of action of fluticasone? Which one is com- monly used to treat serious asthma symptoms? Which one is typically used to prevent serious asthma symptoms?

- How is prednisone different from fluticasone? Is there more of a risk of side effects with prednisone? Why or why not?

- Could the behavioral problems that Leia experienced be the result of the oral steroid? Briefly describe any evidence for this, including how dosage might factor into the incidence of side effects.

Explanation / Answer

By the reports of 2009, about 1 in 12 people in US have asthma. Based on the reports of 2009, about 25 million people have asthma and the number is increasing day by day. Asthma was linked with 3447 death in the year 2007. In the year 2008, more children(57%) than adults(51%) had asthma attacks. Women suffer more than men and boys suffer more than girls with asthma. The greatest rise in asthma rates was seen in black children's (50%) from the year 2001 to 2009.

Asthma costs US 56 billion dollars.

Albuterol is selective beta 2 adrenergic recptor agonist with pharmacological and therapeutic action similar to terbutaline. They relax airway smooth muscles and cause bronchdilation. Smooth muscles has large number beta 2 adrenergic receptor. Albuterol binds to these receptors and activates Gs adenylyl cyclase cyclic AMP pathway causing reduction in smooth muscle tone. Albuterol also increases the conductance of Ca sensitive K channels in smooth muscles leading to membrane hyperpolarization and relaxation.

Fluticasone works by inhibiting inflammatory cells like mast cells, neutrophils, lymphocytes, macrophages. Fluticasone also helps in inhibiting secretions of histamines, cytokines and leukotrines, which are commonly released in condition of asthma and allergic disorders.

Use of asthamatic drugs depends upon age, symptoms, severity, triggers causing asthma and drug response. Albuterol is short acting drug used mainly in exercise induced asthma attack or sudden asthma attack whereas Fluticasone can be used in long term asthma control.

Fluticasone and Prednisone both belongs to class of drugs called as corticosteroids. Whereas Fluticasone is the drug of choice in asthma and breathing disorder, Prednisone can be used for immune system disorder, arthritis, blood disorder, allergic disorder, eye disorder, breathing disorder, skin disease, cancer etc.

Every Drug comes with side effects but we have to see the benefits versus risk ratio. When Fluticasone is compared to Prednisone, it seen that Fluticasone is new generation of corticosteroid compared to Prednisone with least side effects. It has been reported that on long term use Prednisone makes the immune system weak. Fluticasone is mainly available as inhalers hence the drug reaches the systemic circulation fast. Prednisone is available as tablets, capsules(takes more time to reach systemic circulation and has to undergo first pass metabolism) and liquid solutions. The amount of steroid that is absorbed and subsequent side effects vary based upon delivery device, inhaler technique and timing of administration. There is more quality of life improvements with inhaled steroids like Fluticasone.

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