Anaphylaxis in children.
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Biomedical subjects
Publications and source records attributed to J M O'Loughlin.
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Many drugs with which to treat reversible obstructive airway disease are available. Beta-adrenergic aerosols are the first line of defense; these are followed, when necessary, by either timed-release theophylline or oral beta-adrenergics. Often, a combination of these drugs must be used to achieve effective relief of symptoms. Once-daily theophylline preparations can be extremely effective in patients who need regular medication and in whom gastrointestinal upset or compliance is a problem. In patients who have frequent setbacks, occasional courses of tapered doses of steroid are necessary. When oral steroids are necessary regularly, the physician should consider using an aerosol corticosteroid, cromolyn sodium, or both. These drugs can be used daily with relative safety. However, only a small amount (ie, no more than 12%) of an inhaled medication reaches the lungs. In selected patients, regular doses of cromolyn sodium are used for prophylaxis and may preclude the need for theophylline or oral beta-adrenergics, which can have deleterious effects in adults and children. Cromolyn sodium is most effective if used before exercise or exposure to animals. Research is continuing on more effective and longer-acting beta-adrenergic aerosols and oral preparations.
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Infections in the immunosuppressed cancer patient are caused by a wide variety of bacteria, viruses, fungi, and protozoa; many of these in the normal individual are saprophytes but will cause disease in the immunosuppressed patient, often with treatment failure. Patterns of infection are recognized, and this should enable the physician to plan a meaningful course of action when infection occurs in the compromised host. Obviously, it would be much better to prevent rather than have to treat infection in these immunosuppressed patients. Ideally, in the future, it is hoped that drugs which have less suppressive effect on defense mechanisms will provide a partial solution to the problem of infection in the immunosuppressed patient.
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