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A 5 y/o boy is seen in the office because he has developed nocturnal cough and wheezing over the past two wks.He is started on inhaled albuterol, but this only partially relieves his symptoms.He has a history of atopic eczema and allergic rhinitis.What is the most suitable "Long Term" medication for further management of this child's condition?
A-Oral Theophilline
B-Inhaled sodium cromolyn
C-Oral zafirleukast
D-Oral prednisone
E-Ipratropium inhalations
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"B" is right
Pt with Asthma who also have other Allergic D/O (e.g. Rhinitis, eczema)-
"Mast cell stabilizers" are the drug of choice
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ok sarim what if u have a choice between inhaled steroids and cromolyn, which would it be? cos i read an article on wikipedia which said that steroids are preferred to cromolyn in all cases of asthma.
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@saintdizzy Hi
-I do have this confusion as well which may get cleared up at step 2 or step 3 level.
-I have noticed the Qs i have gone over, non of them gave both options (Inhaled Cromolyn and Inhaled Steroids)
-I think Inhaled Mast cell stabilizer is the right choice in this specific situation. Inhaled Steroids may be used if it's not controlled by mast cell stabilizer and in severe cases.
source of the Q : UW
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By and large the prescriptions given out for long term management of asthma are steroidal in nature; cromolyn is an older drug that is rarely prescribed these days. It is prescribed in cases where steroidal side effects are noted; but in this case the newer Lukast have mostly replaced Cromolyn at this point.
I think it'll stay in the literature (and on the USMLE) for a long time, but at this point it is there mostly as a "proof of concept" drug ... kind of like thorotrast (the radioactive contrast dye) is still seen on USMLE questions even though it ceased to be used in the 1950s (!). Cromolyn is on the way out.
