Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are disorders of airway inflammation that are characterized by airflow obstruction. These disease entities demonstrate similar spirometric characteristics including FEV1/FVC <70 % and FEV1 <80 %, with asthma demonstrating reversibility of obstruction with bronchodilator therapy [1, 2]. There is much overlap in the pharmacologic management between asthma and COPD. In both diseases, acute attacks may be treated with inhaled and intravenous β2 agonists, inhaled anticholinergics, and systemic corticosteroids, while chronic management can be accomplished with inhaled agents (short- and long-acting β2 agonists, anticholinergics, or glucocorticoids) or methylxanthines. Chronic management of asthmatic patients can also include mast cell stabilizers, leukotriene modifiers, and immunomodulators, while that of COPD patients may include PDE-4 inhibitors. A brief summary of the impact of anesthetic agents on the patient with asthma is included.
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References
Rennard I. Chronic obstructive pulmonary disease: definition, clinical manifestations, diagnosis, and staging. UptoDate Online. 2013.
Centers for Disease Control and Prevention. Chronic obstructive pulmonary disease among adults – United States, 2011. MMWR Morb Mortal Wkly Rep 2012;61:938.
Miniño AM, Murphy SL, Xu J, Kochanek KD. Deaths: final data for 2008. Natl Vital Stat Rep. 2011;59:1.
Sutherland ER, Martin RJ. Airway inflammation in chronic obstructive pulmonary disease: comparisons with asthma. J Allergy Clin Immunol. 2003;112(5):819.
National Asthma Education and Prevention Program: Clinical Practice Guidelines. Expert Panel Report 3. “Guidelines for the Diagnosis and Management of Asthma.” National Institutes of Health: National Heart, Lung, and Blood Institute. August 2007.
Barreiro TJ, Perillo I. An approach to interpreting spirometry. Am Fam Physician. 2004;69(5):1107–15. http://www.aafp.org/afp/2004/0301/p1107.html.
Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med. 2008;359:2355.
Tucker J, Fanta CH. Integrative inflammation pharmacology: asthma. In: Golan DE, Tashjian AH, Armstrong E, Galanter JM, Armstrong AW, Arnaout RA, Rose HS, editors. Principles of pharmacology: the pathophysiologic basis of drug therapy. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 699–711.
Woods BD, Sladen RN. Perioperative considerations for the patient with asthma and bronchospasm. Br J Anaesth. 2009;103 Suppl 1:i57–65.
Looseley A. Management of bronchospasm during general anaesthesia. Clinical Overview Articles. Update in Anaesthesia. 2011. p. 17–21. http://update.anaesthesiologists.org/…/Bronchospasm_during_anaesthesia_Update_2011.pdf.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: Revised 2011. Global Initiative for Chronic Obstructive Lung Disease (GOLD). www.goldcopd.org.
American Academy of Allergy and Immunology. http://www.aaaai.org/conditions-and-treatments/treatments/drug-guide. 1 Dec 2012.
Ogbru O, et al. RxList: The Internet Drug Index.”WebMD. Accessed July 22, 2013. www.rxlist.com.
Fanta CH. Asthma. N Engl J Med. 2009;360:1002–14.
Nelson HS, Weiss ST, Bleecker ER, Yancey SW, Dorinsky PM, Smart Study Group. The salmeterol multicenter asthma research trial: a comparison of usual pharmacotherapy for asthma or usual pharmacotherapy plus salmeterol. Chest. 2006;129(1):15–26.
Fanta CH. Treatment of acute exacerbations of asthma in adults. Table 1. UpToDate Online. 2012.
Xolair® Omalizumab. http://www.accessdata.fda.gov/drugsatfda_docs/label/2003/omalgen062003LB.pdf. 23 Mar 2013.
Yao FF. Asthma and chronic obstructive pulmonary disease. In: Yao FF, Malhotra V, Fontes ML, editors. Yao & Artusio’s anesthesiology: problem-oriented patient management. 6th edn. Philadelphia: Lippincott Williams & Wilkins; 2008. p 1–28.
Eames WO, Rooke GA, Wu RS, Bishop MJ. Comparison of the effects of etomidate, propofol, and thiopental on respiratory resistance following tracheal intubation. Anesthesiology. 1996;84:1307–11.
Pizov R, Brown RH, Weiss YS, Baranov D, Hennes H, Baker S, Hirshman CA. Wheezing during induction of general anesthesia in patients with and without asthma. A randomized, blind trial. Anesthesiology. 1995;82:1111–6.
Mazzeo AJ, Chen EY, Bosnjak ZJ, Coon RL, Kampine JP. Differential effects of desflurane and halothane on peripheral airway smooth muscle. Br J Anaes. 1996;76:841–6.
Goff MJ, Arain SR, Ficke DJ, Uhrich TD, Ebert TJ. Absence of bronchodilation during desflurane anesthesia. Anesthesiology. 2000;93:404–8.
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Chemical Structures
Chemical Structure 18.1
Formoterol
Chemical Structure 18.2
Cromolyn Sodium
Chemical Structure 18.3
Theophylline
Chemical Structure 18.4
Prednisone
Chemical Structure 18.5
Roflumilast
Chemical Structure 18.6
Montelukast
Chemical Structure 18.7
Terbutaline
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Appelstein, A., Chung, M. (2015). Asthma and COPD Agents. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8948-1_18
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