Long acting beta agonist and corticosteroid

In a 2-year study in SPRAGUE-DAWLEY® rats, albuterol sulfate caused a dose-related increase in the incidence of benign leiomyomas of the mesovarium at the above dietary doses of 2 mg/kg (approximately 15 times the maximum recommended daily inhalation dose for adults on a mg/m² basis and approximately 6 times the maximum recommended daily inhalation dose for children on a mg/m² basis). In another study this effect was blocked by the coadministration of propranolol, a nonselective betaadrenergic antagonist . In an 18-month study in CD-1 mice, albuterol sulfate showed no evidence of tumorigenicity at dietary doses of up to 500 mg/kg (approximately 1700 times the maximum recommended daily inhalation dose for adults on a mg/m² basis and approximately 800 times the maximum recommended daily inhalation dose for children on a mg/m² basis). In a 22-month study in Golden Hamsters, albuterol sulfate showed no evidence of tumorigenicity at dietary doses of up to 50 mg/kg (approximately 225 times the maximum recommended daily inhalation dose for adults on a mg/m² basis and approximately 110 times the maximum recommended daily inhalation dose for children on a mg/m² basis).

Variations in the molecular structure of beta agonists affect the onset and duration of bronchodilation. As an example, prolongation of the bronchodilator effect (relative to isoproterenol) is achieved by modifications that reduce susceptibility to degradation by catechol O-methyl transferase (COMT) and monoamine oxidase [ 2 ]. In addition, the long, lipophilic side chains of formoterol and salmeterol attach to the plasma membrane and increase the duration of binding of the drugs to the adrenergic receptor. The lipophilic side chain of salmeterol leads to incorporation of the drug into the cell membrane and activation of the beta adrenergic receptor through an alternate binding site, rather than the usual site in the aqueous surface of the cell membrane [ 3 ]. It is thought that accessing the alternate binding site deeper in the cell membrane slows the onset of action of salmeterol. In contrast, formoterol has a different lipophilic side chain and its onset of action is comparable to that of albuterol (also known as salbutamol).

While the use of inhaled LABAs are still recommended in asthma guidelines for the resulting improved symptom control, [22] further concerns have been raised, by a large meta-analysis of the pooled results from 19 trials with 33,826 participants, that salmeterol may increase the small risks of asthma deaths, and this additional risk is not reduced with the additional use of inhaled steroids (., as with the combination product fluticasone/salmeterol ). [23] This seems to occur because although LABAs relieve asthma symptoms, they also promote bronchial inflammation and sensitivity without warning. [24]

SOURCES:
American Academy of Asthma, Allergy & Immunology: "Asthma" and "Allergy and Asthma Drug Guide."
National Jewish Medical and Research Center: "Inhaled Medication with a Metered Dose Inhaler (MDI)." 
Asthma Society of Canada: "How to Use Your Inhaler."
Science Daily: "New Asthma Inhaler Propellant Effective, but Costlier."
Children's Hospital Boston: "Allergy Treatment."
Boehringer Ingelheim: "US FDA Expands Approval of Tiotropium Respimat® for Maintenance Treatment of Asthma in Children."
FDA. Prescribing Information: Spiriva Respimat.

A popular benzodiazepine used in the treatment of canine anxiety is alprazolam (Xanax). Alprazolam is an anxiolytic which yields short term CNS sedation as well as anterograde amnesic effects. Anterograde amnesia is also known as short term memory loss . an inability to recall the recent past. The benefit of being able to induce anterograde amnesia alongside general anxiolytic effects is that you are able to administer the drug either before or after a stressful event. The anterograde effect of drugs such as alprazolam make it difficult for the dog recall the event, reducing anxiety and helping to prevent the development of phobias.

Long acting beta agonist and corticosteroid

long acting beta agonist and corticosteroid

SOURCES:
American Academy of Asthma, Allergy & Immunology: "Asthma" and "Allergy and Asthma Drug Guide."
National Jewish Medical and Research Center: "Inhaled Medication with a Metered Dose Inhaler (MDI)." 
Asthma Society of Canada: "How to Use Your Inhaler."
Science Daily: "New Asthma Inhaler Propellant Effective, but Costlier."
Children's Hospital Boston: "Allergy Treatment."
Boehringer Ingelheim: "US FDA Expands Approval of Tiotropium Respimat® for Maintenance Treatment of Asthma in Children."
FDA. Prescribing Information: Spiriva Respimat.

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