HealthCare

HealthDay - TUESDAY, Aug. 26 (HealthDay News) -- The makers of the type 2
diabetes drug Byetta reported Tuesday the deaths of four more people who'd
been taking the medication.

Reuters - An epilepsy drug being tested for
use in treating addiction can help obese rats shed weight, U.S.
government researchers said on Wednesday.

HealthDay - MONDAY, Aug. 25 (HealthDay News) -- A new study identifies some
women -- but not men -- who might be able to stop taking blood-thinning
medication for the clotting condition called venous thromboembolism.

HealthDay - (HealthDay News) -- Here are the latest clinical trials, courtesy
of CenterWatch:

Orciprenaline also known as metaproterenol is a bronchodilator used in the treatment of asthma. Orciprenaline is a moderately selective beta2-adrenergic receptor agonist that stimulates receptors of the smooth muscle in the lungs, uterus, and vasculature supplying skeletal muscle, with minimal or no effect on alpha-adrenergic receptors. The pharmacologic effects of beta adrenergic agonist drugs, such as orciprenaline, are at least in part attributable to stimulation through beta adrenergic receptors of intracellular adenyl cyclase, the enzyme which catalyzes the conversion of ATP to cAMP. Increased cAMP levels are associated with relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from many cells, especially from mast cells.

Pirbuterol commercially available as Maxair is a beta-2 adrenergic bronchodilator used in the treatment of asthma, available (as perbuterol acetate) as a breath-activated metered-dose inhaler. MAXAIR AUTOHALER is a pressurized metered-dose aerosol unit for oral inhalation. It provides a fine-particle suspension of maxair acetate in the propellant mixture of trichioro-monofluoromethane and dichlorodifluoromethane, with sorbitan trioleate. Each actuation delivers 253 mcg of maxair (as maxair acetate) from the valve and 200 mcg of maxair (as maxair acetate) from the mouthpiece. The unit is breath-actuated such that the medication is delivered automatically during inspiration without the need for the patient to coordinate actuation with inspiration.

Maxair is used to treat wheezing and shortness of breath that commonly occur with lung problems (e.g., asthma, chronic obstructive pulmonary disease-COPD). Controlling these symptoms can decrease time lost from work or school. maxair is a bronchodilator (beta-2 receptor agonist) that works by opening breathing passages to make breathing easier. This medicine comes in an inhaler that automatically releases a puff of medicine when you inhale. The inhaler allows the drug to reach deep into the lungs for the most benefit. Because this type of inhaler is used differently than other types, be sure to follow directions closely.

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Indacaterol is an ultra long acting beta-adrenoceptor agonist currently undergoing research. It needs only be taken once a day, unlike the currently available Formoterol and Salmeterol. Such drugs are used in the treatment of chronic obstructive pulmonary disease and asthma.

Indacaterol by Novartis is an effective and well-tolerated treatment of asthma and chronic obstructive pulmonary disease (COPD) over 24 hours with a rapid onset of action. The combination of 24-hour efficacy and a reassuring safety profile suggests that in time, a once-daily dose of indacaterol could become a new standard of care for bronchodilation in asthma and COPD. Indacaterol could be the first beta2-agonist to be taken only once-daily providing full 24 hour symptom control with a single administration, in contrast to currently-available long-acting beta2-agonists (LABAs) such as salmeterol and formoterol which have to be taken twice-daily.

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Xopenex as a bronchodilator is used to treat asthma and COPD. In general, xopenex has similar pharmacokinetic and pharmacodynamic properties to albuterol; however, its manufacturer, Sepracor, has implied (although not directly claimed) that the presence of only the R-enantiomer produces fewer side effects.

Physicians sometimes elect to use xopenex in patients with a history of supraventricular tachycardia or other arrhythmias because it is thought that xopenex may produce less direct effects on beta-adrenergic receptors in the heart. For similar reasons, some pediatricians also use xopenex for patients who experience hyperactivity or jitteriness from racemic albuterol.

The use of xopenex over the more traditionally used racemic albuterol is controversial among health care professionals. That using xopenex instead of albuterol produces less direct effect on beta adrenergic receptors and/or fewer cardiac side effects has been suggested, but not consistently demonstrated by long term, well-designed clinical trials.

There are differing opinions on whether there is sufficient therapeutic benefit to using xopenex that outweighs the 5-10 times higher price tag. In general, it appears that if a clinician and patient feel that a low dose of racemic mixture is causing undesirable side effects, xopenex may be a viable alternative. xopenex was originally available only as a solution for nebulizer and eventually become available as a CFC-free metered dose inhaler under the trade name Xopenex HFA (xopenex tartrate) Inhalation Aerosol.

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Clenbuterol is a drug to releive breathing disorders and acts as a decongestant and bronchodilator. People with chronic breathing disorders like asthma use this as a bronchodilator to make breathing easier. It is most commonly available in salt form as Clenbuterol hydrochloride.

Clenbuterol is a beta adrenergic agonist similar to ephedrine, but its effects are more potent and longer-lasting as a stimulant and thermogenic drug. It causes an increase in aerobic capacity, central nervous system stimulation, and an increase in blood pressure and oxygen transportation. It increases the rate at which fat and protein is used up in the body at the same time as slowing down the storage of glycogen. It is commonly used for smooth muscle relaxant properties. This means that it is a bronchodilator and tocolytic. It is usually used in dosages anywhere from 20-60 micrograms a day when prescribed. A dose of about 150 % should never be exceeded in a day. It is also prescribed for treatment of horses; however, equestrian usage is usually the liquid form of clenbuterol. Clenbuterol is also a sympathomimetic in the peripheral nervous system. Clenbuterol produced for human consumption is generally in tablet form. The most common veterinarian preparation is a syrup. Clenbuterol is not approved for human use in Australia and is also banned under the Olympic Movement's World Anti-Doping Code Prohibited Classes of Substances and Prohibited Methods.

Clenbuterol is approved for use in some countries as a bronchodilator for asthma patients. Recently though, the drug has been publicized for its off-label use as a weight loss drug. It is commonly used as a slimming aid despite lack of sufficient clinical evidence supporting such use. With many major diet review websites talking about clenbuterol, and given its accessibility via the internet, the drug is widely used as a "dietary supplement". In fact, nowadays it is recommended by many physical trainers as the primary solution for those bodybuilders who desire to achieve sufficiently low body fat in order to look "cut". In many cases, it is introduced into the training regime not as an illegal drug, but simply as a weight loss aid. This reduces some of the negative connotations attached to illicit drug use and thereby decreases any hesitation to take the drug on the part of the trainee.

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Clenbuterol is used worldwide for the treatment of allergic respiratory disease in horses, as it is a bronchodilator. A common trade name is Ventipulmin. It can be used both orally and intravenously. It is also a non-steroidal anabolic and metabolism accelerator, through a mechanism not well understood. Its ability to induce weight loss and a greater proportion of muscle to fat makes its illegal use in livestock popular.

The common side effects of clenbuterol include Headaches, Tremors, Cramps, Restlessness, Anxiety, Insomnia, Sweating, Increased appetite, Nausea, Palpitations, Nausea and Hypertension (high blood pressure). Clenbuterol is known to cause very high blood pressure resulting in serious cardiac problems. Unsupervised use of clenbuterol could exacerbate pre-existing heart conditions or hypertension. There is a risk of overdose and stroke when used at high doses. There have been reports of sudden deaths among bodybuilders on clenbuterol, although it is unclear whether this was the result of clenbuterol or other drug combinations. There are also some very negative effects on their hearts when used long term. The hearts of rats on clenbuterol increased in size due to the infiltration of collagen fibres into the heart wall. Collagen is a tough connective tissue that can stiffen the heart muscle, actually reducing cardiac output and possibly producing cardiac arrhythmias. Also, clenbuterol Rats suffered from noticeable cardiac-cell degeneration.

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The long-acting beta-adrenergic agonists are very effective in the management of asthma . Most often, beta-adreneigic agonists are inhaled using metered-dose inhalers (handheld cartridges containing gas under pressure}. The pressure pumps the drug into a fine spray containing a measured dose of drug. Inhalation deposits the drug directly in the airways, so that it acts quickly, but the drug may not reach the airways that arc severely obstructed. For people who have difficulty using a metered-dose inhaler, spacers or holding chambers can be used. With any type of inhaler, proper technique is vital; if the device is not used properly, the drug will not reach the airways. A dry powder drug formulation is also available. The powder formulation is easier for some people to use, in part because it requires less coordination with breathing.

Beta-adrenergic agonists can also be delivered directly to the lungs by using a nebulizer. A nebulizer creates a mist of drug, and its use does not have to be coordinated with breathing. Nebulizers arc more portable than they were in the past; some units can even be plugged into a cigarette lighter in a car. Beta-adrenergic agonists can also be taken in liquid or tablet form or injected. However, the oral drugs tend to work slower than the inhaled or injected ones and are more likely to cause side effects. Side effects include abnormal heart rhythms, which may suggest excessive use. Other bronchodilators may be combined with beta-adrenergic agonists for acute attacks, including intravenous infusions of aminophylline (a type of theophylline) and nebulized ipratropium. Overusing these drugs can be very dangerous. The need for continuous use indicates severe bronchoconstriction, which can lead to respiratory failure and death.

There are currently around 26 Popular beta-adreneigic agonists molecules in the market. They are : Amibegron, Arformoterol, Bambuterol,Bitolterol, Bromoacetylalprenololmenthane, Carbuterol, Clenbuterol, Dopexamine, ormoterol, Hexoprenaline, Indacaterol,Levosalbutamol, Orciprenaline, Pirbuterol, Procaterol, Ractopamine, Reproterol, Rimiterol, Salbutamol, Salmeterol, Solabegron, Terbutaline and Tulobuterols.

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Leukotriene Modifiers: Leukotriene modifiers, such as montclukast, zafirlukast, and zileuton, are the new asthma medications. They are anti-inflammatory drags, preventing the action or synthesis of leukotrienes, chemicals made by the body that cause bronchoconstriction. These drugs, which are taken by mouth, are used more to prevent asthma attacks than to treat them, although because leukotrienes arc increased in acute asthma, these drugs potentially can be used during an attack as well.

Corticosteroids: These drugs block the body's inflammatory response and are exceptionally effective at reducing asthma symptoms. They are the most potent form of anti-inflammatory drugs and have been an important part of asthma treatment for decades. They are given in the inhaled form to prevent attacks and improve lung function. They are given by mouth in higher doses for people experiencing severe attacks. Corticosteroids given by mouth are generally continued for at least several days after a severe attack. Corticosteroids can be taken in several different forms. Often, inhaled versions are best because they deliver the drug directly to the airways and minimize the amount sent throughout the body. They come in several strengths and are generally used twice a day. The person should rinse the mouth after use to decrease the likelihood that an infection of the mouth (thrush) develops.

Oral or injected corticosteroids may be used in high doses to relieve a severe asthma attack and are generally continued for I to 2 weeks. Oral corticosteroids are prescribed on a long-term basis only when no other treatments can control the symptoms. If taken for long periods, corticosteroids gradually reduce the likelihood of an asthma attack by making the airways less sensitive to a number of provocative stimuli. Long-term use of orticosteroids, especially larger doses taken by mouth, can produce side effects.

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Because people with severe asthma commonly have low blood oxygen levels, a doctor may check the level of oxygen either by using a sensing monitor on a finger or ear or by taking a sample of blood from an artery . Supplemental oxygen may be given during attacks. However, in severe attacks, a doctor also needs to monitor carbon dioxide levels, and this test requires a sample of blood from an artery. A doctor may also check pulmonary function, usually with a spirometer or a peak flow meter. Usually, a chest x-ray is needed only in severe asthma attacks. People experiencing very severe asthma attacks may need to have an artificial airway passed through their mouth and throat and be placed on a mechanical ventilator.

Generally, people who have severe asthma are admitted to the hospital if their lung function does not improve after receiving a beta-adrenergic agonist and corticosteroids or if they have a seriously low blood oxygen level or a high blood carbon dioxide level. Intravenous fluids may be needed if the person is dehydrated. Antibiotics also may be needed if a doctor suspects a lung infection; however, most such infections are due to viruses’ for which no treatment exists.
 
Drugs for Preventing or Treating Asthma Attacks
Drugs allow most people with asthma lo lead relatively normal lives. Most of the drugs used to treat an asthma attack can be used to prevent attacks.
Short-acting Beta-adrenergic Agonists: Short-acting beta-adrenergic agonists are usually the best drugs for relieving asthma attacks. They can prevent certain attacks, such as exercise-induced asthma. These drugs are also referred to as bronchodilators because they stimulate beta-adrenergic receptors to widen and dilate  the airways. Bronchodilators that act on all beta-adrenergic receptors throughout the body, such as epinephrine, cause side effects such as rapid heartbeat, restlessness, headache, and muscle tremors. Bronchodilators such as albuterol act mainly on beta2-adrenergic receptors, which are found primarily on cells in the lungs. They have little effect on other organs and thus cause fewer side effects. Most beta-receptor agonists, especially the inhaled ones, act within minutes, but the effects last only 3 to 7 hours. New, longer-acting bronchodilators are available, but because they do not begin to act as quickly, they are used for prevention rather than for attacks of asthma.

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