A study of children with asthma found that symptoms usually develop within 30 to minutes, but can take up to 24 hours. Most people with asthma can safely take acetaminophen Tylenol to treat fever or pain. Certain asthma medications block leukotrienes. These include zafirlukast Accolate , montelukast Singulair , and zileuton Zyflo.
Ask your doctor if these medicines affect your ability to take ibuprofen. Your doctor can also guide you on the safest pain relievers, potential side effects, and what to do if you have an allergic reaction. For frequent or chronic pain, your doctor may be able to provide alternate solutions based on the cause.
Seek emergency medical care or call if you have symptoms of severe allergic reaction such as:. Of course, any medicine can result in an allergic reaction. Tell your doctor if symptoms of asthma get worse after taking a new medicine. If possible, use a peak flow meter to measure any changes to air flow, and report changes that occur after taking medicine. How is brittle asthma different from regular asthma? These symptoms resolve in a few weeks and may be followed by persistent rhinitis and the development of nasal polyps.
Identification of aspirin-sensitive individuals is not merely a matter of asking whether they have experienced symptoms with a previous ingestion of NSAIDs. This does not exclude the possibility of a reaction as many patients may have had NSAIDs in the past with no ill-effect.
Prescribers should determine whether their patient is an asthmatic or has nasal polyps. Patients with a history of asthma should be warned of this reaction and to seek medical help if symptoms worsen on initiation of a NSAID. A genetic polymorphism of the LTC4S gene has been identified consisting of an A to C transversion nucleotides upstream of the first codon, conferring a relative risk of AIA of 3. Furthermore, carriers of the C allele demonstrate a dramatic rise in urinary LTE 4 following aspirin provocation, and respond better to the cys-LT antagonist pranlukast than A homozygotes.
AIA patients have an aggressive form of disease, and treatment should include combination therapy with inhaled corticosteroids, beta 2 -adrenoceptor agonists and LT modifiers. Abstract Aspirin acetylsalicylic acid -induced asthma AIA consists of the clinical triad of asthma, chronic rhinosinusitis with nasal polyps, and precipitation of asthma and rhinitis attacks in response to aspirin and other NSAIDs. By the end of the study period, patients 6. Consistent with previous studies, [ 28 , 29 ] the prevalence of asthma was higher in boys The highest density of children with asthma was found in Taipei and northern Taiwan, accounting for Furthermore, atopic asthma accounts for approximately a quarter of patients with asthma Allergic rhinitis, observed in up to There was no significant difference in the demographic characteristics between the 2 groups.
The index group had a higher RR of asthma-related hospitalization RR: 1. Stratified hospital days and cost of asthma-related hospitalization in children with asthma from to in Taiwan. After adjustment for sex, age, insured region, asthma classification, number of comorbidities, and type of antiasthmatic agent, ibuprofen had the highest usage rate in 1 to 2 days before asthma-related hospital admission.
Compared with the reference group, the index group had a higher percentage of exposure to ibuprofen, diclofenac, in 1 to 2 days before asthma-related hospital admission ibuprofen: aOR: 3. Compared with other NSAIDs, patients with cumulative exposure to diclofenac, aspirin, and ketoprofen were at a nonsignificantly higher risk of asthma-related hospitalization.
Numerous problems are associated with asthma when conventional antiasthma medicines—which decrease resistance in the respiratory airway and increase airflow to the lungs—and NSAIDs—which may cause bronchospasms—are taken simultaneously by children with asthma, resulting in an unpredictable outcome for asthma control. This study demonstrates that NSAIDs use was associated with an increased risk of asthma exacerbation. In general, NSAID-induced bronchospasm develops within 30 to minutes sometimes up to 24 hours after drug ingestion, [ 30 ] possibly precipitating the asthma exacerbation.
To examine the short-term effects of NSAIDs on asthma exacerbation, we analyzed the population hospitalized for asthma and defined the NSAID exposure time 1 to 2 days before hospitalization as our assessment point.
During the study period, children with asthma were exposed to aspirin, and 9 of them developed an acute asthma exacerbation within 48 hours after aspirin use. Therefore, it can be inferred that the incidence of AIA among children with asthma in Taiwan was approximately 3. It is not surprising that the prevalence rate of AIA based on aspirin provocation tests is higher than that based on the requirement for hospital admission.
Both physicians and parents should be aware of the association between the concurrent use of antiasthmatic agents and aspirin and potential risk of acute asthma exacerbation in children with asthma.
Therefore, early diagnosis is essential in sensitive populations, and further management is required to prevent severe AIA exacerbation among vulnerable patients with asthma in Taiwan.
In addition, the study results demonstrate that ibuprofen, diclofenac, mefenamic acid, naproxen, ketoprofen, and flurbiprofen were the 6 most prescribed NSAIDs for relieving pain or fever-like symptoms among children with asthma in Taiwan, and short-term use of ibuprofen and diclofenac increases the risk of asthma-related hospitalization. Because ibuprofen has stronger analgesic effects than does acetaminophen, [ 31 ] it has been the most frequently prescribed for treating fever or relieving pain in children.
To our knowledge, this is one of the first observational studies to prove that the risk of asthma exacerbation is associated with the short use of NSAIDs in children whose asthma is under control.
This study urges the physicians to reassess their treatment strategies for fever in children with asthma. In addition, further research on optimal treatments and the long-term outcomes of NSAID-induced asthma exacerbation are warranted. The present study has 4 limitations. However, because the NHI system covers all prescriptions by qualified physicians after careful examinations, providing affordable, accessible, and convenient asthma healthcare, the likelihood of parents purchasing over-the-counter NSAIDs is not high.
Second, because the medical records were retrospective, we were unable to ensure whether children with asthma had taken their prescribed NSAIDs. Third, owing to the lack of actual clinical data, we are unable to draw any conclusions on how the severity of asthma-related symptoms is associated with NSAIDs use. Finally, the lack of personal air pollution exposure data precluded an analysis of the association between individual exposure and asthma-related hospitalization.
Therefore, the aRR of asthma exacerbation for each insured region was used to determine the effects of air pollution on the asthmatic children. Traffic is the major source of air pollutants in Taipei, [ 37 ] whereas in central Taiwan, fine particles are produced primarily by thermal power plants [ 23 ] ; a higher RR was observed in the effect estimates for northern Taiwan than for central Taiwan, indicating that the type and amount of air pollutants differentially influence the risk of asthma exacerbation in children taking antiasthma medication alone and in those receiving a combination of antiasthma medication and NSAIDs in Taiwan.
Therefore, we adjusted for the insured regions in the final analysis. Secondhand smoking can also be a risk factor for asthma exacerbation [ 38 ] ; the Taiwan government prohibited smoking in public places, including schools, nurseries, restaurants, and kindergartens, since Short-term aspirin, ibuprofen, and diclofenac consumption is probably correlated with asthma exacerbation. Long-term aspirin, ibuprofen, and diclofenac consumption were not related to asthma-related hospitalization.
The authors have no conflicts of interest to disclose. Supplemental Digital Content is available for this article. National Center for Biotechnology Information , U. Journal List Medicine Baltimore v. Medicine Baltimore.
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