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Medication Efficacy and Side Effects in Older Asthmatics

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Treatment of Asthma in Older Adults

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Abstract

The older adult asthmatic population is increasing, as is the complexity of asthma treatments. This segment of asthmatics has been understudied, and modalities of therapy are affected by the aging process and comorbid diseases. Corticosteroids are the mainstay of emergency care and of chronic persistent asthma care. Inhaled bronchodilators have proven effective both in the acute setting and as an add-on therapy for chronic control. Leukotriene inhibitors have value especially where inhaler techniques are problematic. Theophylline has bronchodilator and potentially anti-inflammatory effects but requires close monitoring of drug levels. Specific allergen immunotherapy using both subcutaneous and sublingual routes of administration may have value in disease modification but requires further evaluation in the older adult. Biological therapies are available for severe asthma but require further controlled studies in older adults. Complementary medical methodologies are commonly used by patients but not adequately evaluated for efficacy or safety in older adults. Vaccines and good adherence measures are essential due to the polypharmacy and comorbidities inherent to an older adult population.

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Acknowledgments

Rebecca A Goldberg RN, BS Acct., Barbara A. Gushrowski, MLS, Manager of Library Services at Community Health Network, Indianapolis, Indiana.

Potential Conflicts of Interest

Consultant and or Speaker for AstraZeneca, Genentech, Boehringer Ingelheim, Circassia, Shire.

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Authors and Affiliations

  1. Indiana University School of Medicine, Indianapolis, IN, USA

    Pinkus Goldberg

  2. Internal Medicine, Community Hospitals Health Care System of Indiana, Indianapolis, IN, USA

    Pinkus Goldberg

  3. Allergy Partners of Central Indiana, Indianapolis, IN, USA

    Pinkus Goldberg

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Editors and Affiliations

  1. Division of Immunology, Allergy and Rheumatology, University of Cincinnati School of Medicine, Cincinnati, OH, USA

    Tolly E. G. Epstein

  2. Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL, USA

    Sharmilee M. Nyenhuis

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Goldberg, P. (2019). Medication Efficacy and Side Effects in Older Asthmatics. In: Epstein, T., Nyenhuis, S. (eds) Treatment of Asthma in Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-030-20554-6_6

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