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Generally
the drugs are meant to cure a particular disease but some times,
inadvertently, these can trigger asthma. Pros and cons of
popularly marketed drugs which could lead an asthma patient to a
misery must be known. Following groups of drugs may aggravate
asthma in some patients.
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| Medicines
used for pain
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In approximately 20 percent
of adults asthmatic patients, the use of aspirin for
relieving pain can worsen asthma. Usually aspirin like
drugs trigger asthma in those patients in whom allergic
factors are not important (intrinsic asthma). The
patients sensitive to aspirin are usually also sensitive
to other pain killers also. However, majority of
asthmatic patients can take these medicines safely. Those patients
with previous history of aggravation of symptoms with
any of the pain relieving medicines should cautiously
avoid these medicines.
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If
you get asthma with aspirin like pain killer
medicine, you should not take following pain
killer medicines,
Salicylate:
Micropyrin, disprin (Colsprin), Apidin, Asabuf,
Eugesic, Winsprin, ASA.
Ibuprofin:
Brufen, Novigan,
Alfam,Ibudoss, Ibugesic, Ibusynth,
Parvon forte.
Ketorolac:
Ketorol, Ketonov,
Kelac, Torolac, Torvin.
Phenylbutazone:
Zoladin.
Oxyphenylbutazone :
Suganril,Flammer,Butadex.
Naproxen:
Artagen, Xenobid,
Nalyxan, Naprosyn.
Piroxicam:
Brexic, Pirox,
Piricam, Toldin.
Diclofenacsodium:
DICSR, voveron,
Dicloran,Doflex, Diclogesic, Diclomax, Dolonex,
Declonac, relaxl.
Indomathecin:
Indocap, Indocid,
Licin.
Majority of
such aspirin sensitive patients should use Paracetamol
and Nimesulide as safe pain relieving medicines.
Salicylate
containing foods
Apart from drugs, an aspirin like compound also exist in
natural form of foods especially in grapes, apple and
any of their derivatives. In certain sensitive
individuals even these fruits may also precipitate
asthma.
If your symptoms are triggered by aspirin then just
observe triggering action of these fruits. If these do
not aggravate your symptoms then you need not avoid such
fruits. Majority of asthmatic patients are not sensitive
and they can take grapes and apple without any problem.
Drugs used
in hypertension and heart disease
Beta-blockers
drugs
These
are used frequently in hypertension and
heart diseases, can aggravate asthma. The
severity of asthma is directly proportionate
to the dose of the drug taken. Even
beta-blocker drug used as eye drops can also
precipitate asthma. Therefore, all asthmatic
patients should avoid these medicines.
Examples of Beta-blockers
drugs are:
Propranolol: Ciplar, Betaspan, Inderal.
Atenolol: Tenornim, Tensimin, Atelol, Altol,
Atecor,Betacard, Betatrop, Calbeta, Lonol, Presolar,
Tenolol, Tenofed.
Metaprolol: Betaloc, Metolar. |
Angiotensin
converting enzyme (ACE) inhibitors
This is another group
of drugs used in hypertension and heart disease.
Though, these drugs do not cause deterioration of
asthma yet 10 percent patients are sensitive to
develop intractable cough, which appears as
worsening of asthma. Therefore, if any of these
patients on ACE inhibitors drugs develop
intractable cough he/she should tell a doctor.
Barring a few patients most of the asthmatic
patients tolerate these drugs without significant
side-effects. These drugs include Captopril,
Enalapril, Lisinopril etc.
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| Food
additives and preservatives |
| Metabisulfites,
Tartarazine and Benzoate are employed as
preservative or as coloring agents in many
edibles. Sometimes asthmatic individuals,
specially those sensitive to aspirin, are
also sensitive to these agents and develop
asthma when they eat such food. These
include preserved fruits, vegetables, wine,
beer, fresh fruits, drinks and dry fruits. |
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| Miscellaneous |
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- Sulphite
preservatives of important medicine of allergy
such as Adrenaline and Hydrocortisone can also
trigger asthma. Both these drugs are important in
management of acute severe asthma.
- In some
sensitive asthmatic patients propellent of
inhalers can also aggravate asthma.
- Nebuliser
use in asthma, if solution is diluted with water
instead of normal saline can trigger asthma in
small number of patients.
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Action plan to deal with drugs worsening asthma |
| Suspect |
- If
on starting a new medicine you notice any
deterioration in asthma.
- Asthma
is aggravated without any obvious reason
specially after use of processed food.
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| Confirm |
- Read
the composition of the medicine and try to match
with the above list. Consult your doctor to
ensure the possibility of suspect causing asthma
aggravation. Allergy testing or challenge
testing will confirm the suspect.
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| Avoid |
- Should
develop a habit of reading composition of the
drugs prescribed to you for asthma or any other
ailments. Avoid those drugs to which you are
sensitive. If you are sensitive to aspirin you
should avoid other compounds of aspirin group as
well.
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How
an Analgesic triggers asthma?
Example:
An asthmatic patient,
working as an executive officer, used to
develop headache during morning hours. The
cause of his morning headache came out to be
hypertension after a detailed evaluation.
However, his asthma was very stable and
keeping precautions of avoiding trigger
contact. He did not require any medicine for
last one year and therefore he forgot to
inform his family doctor that he had
rudimentary asthma as well. The doctor
attending on him prescribed the tablets
Atenolol 100 mg daily. Patient's blood
pressure came down to normal in 2-3 days and
his headache disappeared. But in next few
days his asthma aggravated and he felt
difficulty in breathing.
Curiosity:
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What led to an aggravated asthma in the
executive officer?
- How the
problem was solved?
When the
doctor was informed by the executive that he
had asthmatic history the doctor discontinued
Atenolol, the drug executive was sensitive
against. This led to improvement in his
asthma.
Expert
Comments:
This
patient had asthma which was controlled adequately with
precautions. Atenolol is a beta blocker drug which was
prescribed for hypertension. Intake of this medicine
triggered his asthma. Therefore every asthmatic patient
should tell to his doctor about his asthma.
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