ASTHMA PHARMACOTHERAPY - CURRENT PRACTICES AND OUTLOOK

Owing to its high incidence and rapidly increasing prevalence in the U nited States population, and to the billions of dollars in associated costs, asthma is a significant public health problem. A variety of pha rmacologic agents exist to manage asthma, but their efficacies vary, a s do their costs. Recently published guidelines on asthma management s et forth a four-step approach that is guided by severity of disease an d symptom control. These guidelines also suggest increased use of anti inflammatory agents; primarily inhaled corticosteroids, which carry a higher cost. Shifts in prescribing patterns among physicians who treat patients with asthma indicate that the guidelines are being adopted t o some extent. However, some reluctance toward widespread use of corti costeroids remains, due to potential adverse effects as well as cost c onsiderations. Alternatives to increased or high-dose corticosteroid u se include combination therapy with long-acting bronchodilators. Newer medications that have more specific mechanisms of action, such as leu kotriene synthesis inhibitors and leukotriene receptor antagonists, ma y offer another option.