Advances in inhaled corticosteroid pharmacology.

Inhaled corticosteroids have been the backbone of asthma therapy for the past 20 plus years. Although they have, for the most part, been effective in controlling asthma symptoms and preventing exacerbations, not all patients are universally responsive to their beneficial effects. In addition, several recent studies have failed to demonstrate a disease-modifying effect of inhaled corticosteroids, with clinically indicated doses failing to prevent long term deterioration in lung function and potential airway "remodeling".

Optimal management of community-acquired acute bacterial rhinosinusitis: the allergist's perspective.

Objectives: To characterize the antibiotic resistance seen in community-acquired respiratory tract infections (RTIs) and determine which characteristics to look for in an antibiotic to improve clinical outcomes and decrease the potential for development of resistance.

Data Sources: Using MEDLINE, we performed a search of articles published from 1966 to 2004 to evaluate the current literature on the subject of antibiotic resistance and strategies to overcome it. Additional cited references, such as abstracts, were also identified.

Properties of the ideal corticosteroid therapy.

Currently, inhaled corticosteroids (ICSs) are the most effective long-term control therapy for persistent asthma. However, patients show a variable response to ICSs and some exhibit glucocorticoid resistance. At recommended doses, there is little evidence to suggest that ICSs can either prevent or reverse the chronic airflow limitation that develops in some asthma patients.

The role of nonsedating antihistamines in asthma therapy.

There is well-established evidence that histamine plays a significant role as a chemical mediator in asthma. However, although antihistamines are commonly used for the treatment of allergic rhinitis, their use in asthma has been somewhat controversial. Mechanistically, their application for asthma appears logical.