Глобальная стратегия лечения бронхиальной астмы - часть 22

чувствительностью к НПВП и потребностью в этих пре
паратах для лечения других заболеваний может прово
диться десенситизация – в условиях больницы и под
наблюдением специалиста [337]. Десенситизация к ас
пирину также используется для лечения аспириновой
БА, однако при длительном лечении показано, что эф
фект в отношении синусита отмечается чаще, чем
уменьшение симптомов со стороны нижних дыхатель
ных путей. После десенситизации к аспирину ежеднев
ный прием 600–1200 мг аспирина может уменьшить
симптомы воспалительного процесса в слизистой обо
лочке (особенно полости носа) у большинства больных
аспириновой БА [332].

В целом больным БА, особенно с началом заболева

ния во взрослом возрасте и сопутствующими заболе
ваниями верхних дыхательных путей (полипоз носа),
следует рекомендовать воздерживаться от приема
НПВП и заменить их на препараты ацетаминофена/па
рацетамола.

Анафилаксия и бронхиальная астма
Анафилаксия – угрожающее жизни состояние, которое
может имитировать или осложнять тяжелую БА. Для эф
фективного лечения анафилаксии необходима ее ран
няя диагностика. Врачи в любом учреждении всегда
должны помнить, что при назначении лекарственного
средства или биологического вещества, особенно пу
тем инъекции, существует риск развития анафилаксии.
Примерами документально подтвержденных причин
анафилаксии служат введение аллергенов при проведе
нии иммунотерапии, употребление отдельных продук
тов при их непереносимости (орехов, рыбы, моллюсков,
яиц, молока), введение вакцин, в состав которых входит
яичный белок, укусы насекомых, аллергия на латекс,
прием лекарственных препаратов (

βлактамных анти

биотиков, аспирина и НПВП, ингибиторов ангиотензин
превращающего фермента), физическая нагрузка.

К симптомам анафилаксии относятся: приливы (по

краснение лица), зуд, крапивница, ангионевротический
отек; симптомы со стороны верхних и нижних дыха
тельных путей, такие как стридорозное дыхание, одыш
ка, свистящие хрипы или остановка дыхания; голово
кружение или обморок с артериальной гипотонией или
без нее; симптомы со стороны желудочнокишечного
тракта, такие как тошнота, рвота, спазмы в животе и
диарея. Анафилаксия, вызванная физической нагруз
кой, часто сочетается с лекарственной или пищевой ал
лергией и представляет собой уникальную разновид
ность аллергической реакции на физическую нагрузку.
Ее следует дифференцировать с бронхоспазмом, вы
званным физической нагрузкой [338].

При тяжелой БА анафилактические реакции со сто

роны дыхательных путей могут быть причиной внезапно
развивающихся приступов БА и относительной резис
тентности приступов к увеличению доз 

β

2

агонистов

[180]. При подозрении на то, что приступ БА может
быть связан с анафилаксией, препаратом выбора для
расширения бронхов является адреналин. Экстренное
лечение анафилаксии крайне важно и заключается в

назначении кислорода, внутримышечном введении ад
реналина, внутривенном введении антигистаминных
препаратов, ГКС (гидрокортизона), обеспечении про
ходимости верхних дыхательных путей и проведении
инфузионной терапии. Профилактика рецидивов ана
филаксии состоит в выявлении причины и обучении па
циентов тому, как избегать подобного воздействия и
как самостоятельно оказать себе неотложную помощь
путем введения адреналина с помощью «готовых»
(предварительно заполненных) шприцев [339].

СПИСОК ЛИТЕРАТУРЫ

1. 

Charlton I, Charlton G, Broomfield J, Mullee MA. Evaluation of
peak flow and symptoms only self management plans for control
of asthma in general practice. BMJ 1990;301(6765):13559.

2. 

Cote J, Cartier A, Robichaud P, Boutin H, Malo JL, Rouleau M,
et al. Influence on asthma morbidity of asthma education pro
grams based on selfmanagement plans following treatment
optimization. Am J Respir Crit Care Med 1997;155(5):150914.

3. 

IgnacioGarcia JM, GonzalezSantos P. Asthma selfmanage
ment education program by home monitoring of peak expiratory
flow. Am J Respir Crit Care Med 1995;151(2 Pt 1):3539.

4. 

Jones KP, Mullee MA, Middleton M, Chapman E, Holgate ST.
Peak flow based asthma selfmanagement: a randomised con
trolled study in general practice. British Thoracic Society
Research Committee. Thorax 1995;50(8):8517.

5. 

Lahdensuo A, Haahtela T, Herrala J, Kava T, Kiviranta K,
Kuusisto P, et al. Randomised comparison of guided self man
agement and traditional treatment of asthma over one year. BMJ
1996;312(7033):74852.

6. 

Turner MO, Taylor D, Bennett R, FitzGerald JM. A randomized
trial comparing peak expiratory flow and symptom selfmanage
ment plans for patients with asthma attending a primary care
clinic. Am J Respir Crit Care Med 1998;157(2):5406.

7. 

Sommaruga M, Spanevello A, Migliori GB, Neri M, Callegari S,
Majani G. The effects of a cognitive behavioural intervention in
asthmatic patients. Monaldi Arch Chest Dis 1995;50(5):398402.

8. 

Cowie RL, Revitt SG, Underwood MF, Field SK. The effect of a
peak flowbased action plan in the prevention of exacerbations
of asthma. Chest 1997;112(6):15348.

9. 

Kohler CL, Davies SL, Bailey WC. How to implement an asthma
education program. Clin Chest Med 1995;16(4):55765.

10.  Bailey WC, Richards JM, Jr., Brooks CM, Soong SJ, Windsor RA,

Manzella BA. A randomized trial to improve selfmanagement
practices of adults with asthma. Arch Intern Med
1990;150(8):16648.

11.  Murphy VE, Gibson PG, Talbot PI, Kessell CG, Clifton VL. Asthma

selfmanagement skills and the use of asthma education during
pregnancy. Eur Respir J 2005;26(3):43541.

12.  Shah S, Peat JK, Mazurski EJ, Wang H, Sindhusake D, Bruce C,

et al. Effect of peer led programme for asthma education in ado
lescents: cluster randomised controlled trial. BMJ
2001;322(7286):5835.

13.  Guevara JP, Wolf FM, Grum CM, Clark NM. Effects of education

al interventions for self management of asthma in children and
adolescents: systematic review and metaanalysis. BMJ
2003;326(7402):13089.

14.  Griffiths C, Foster G, Barnes N, Eldridge S, Tate H, Begum S,

et al. Specialist nurse intervention to reduce unscheduled asth
ma care in a deprived multiethnic area: the east London ran
domised controlled trial for high risk asthma (ELECTRA). BMJ
2004;328(7432):144.

92 ПРОГРАММА ЛЕЧЕНИЯ И ПРОФИЛАКТИКИ БРОНХИАЛЬНОЙ АСТМЫ

15.  Powell H, Gibson PG. Options for selfmanagement education

for adults with asthma. Cochrane Database Syst Rev
2003(1):CD004107.

16. Gibson PG, Powell H, Coughlan J, Wilson AJ, Abramson M,

Haywood P, et al. Selfmanagement education and regular prac
titioner review for adults with asthma. Cochrane Database Syst
Rev 2003(1):CD001117.

17.  Haby MM, Waters E, Robertson CF, Gibson PG, Ducharme FM.

Interventions for educating children who have attended the
emergency room for asthma. Cochrane Database Syst Rev
2001;1.

18.  Gibson PG, Powell H, Coughlan J, Wilson AJ, Hensley MJ,

Abramson M, et al. Limited (information only) patient education
programs for adults with asthma. Cochrane Database Syst Rev
2002(2):CD001005.

19.  Cabana MD, Slish KK, Evans D, Mellins RB, Brown RW, Lin X,

et al. Impact care education on patient outcomes. Pediatrics
2006;117:214957.

20.  Levy M, Bell L. General practice audit of asthma in childhood.

BMJ (Clin Res Ed) 1984;289(6452):11156.

21.  Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctorpatient

communication: a review of the literature. Soc Sci Med
1995;40(7):90318.

22.  Stewart MA. Effective physicianpatient communication and

health outcomes: a review. CMAJ 1995;152(9):142333.

23.  Partridge MR, Hill SR. Enhancing care for people with asthma:

the role of communication, education, training and selfmanage
ment. 1998 World Asthma Meeting Education and Delivery of
Care Working Group. Eur Respir J 2000;16(2):33348.

24.  Clark NM, Gong M, Schork MA, Kaciroti N, Evans D, Roloff D,

et al. Longterm effects of asthma education for physicians on
patient satisfaction and use of health services. Eur Respir J
2000;16(1):1521.

25.  Cegala DJ, Marinelli T, Post D. The effects of patient communi

cation skills training on compliance. Arch Fam Med
2000;9(1):5764.

26.  Chapman KR, Voshaar TH, Virchow JC. Inhaler choice in primary

care. Eur Respir Rev 2005;14(96):11722.

27.  Dolovich MB, Ahrens RC, Hess DR, Anderson P, Dhand R, 

Rau JL, et al. Device selection and outcomes of aerosol therapy:
Evidencebased guidelines: American College of Chest
Physicians/American College of Asthma, Allergy, and
Immunology. Chest 2005;127(1):33571.

28.  Voshaar T, App EM, Berdel D, Buhl R, Fischer J, Gessler T, et al.

[Recommendations for the choice of inhalatory systems for drug
prescription]. Pneumologie 2001;55(12):57986.

29.  Meade CD, McKinney WP, Barnas GP. Educating patients with

limited literacy skills: the effectiveness of printed and videotaped
materials about colon cancer. Am J Public Health
1994;84(1):11921.

30.  Houts PS, Bachrach R, Witmer JT, Tringali CA, Bucher JA,

Localio RA. Using pictographs to enhance recall of spoken med
ical instructions. Patient Educ Couns 1998;35(2):838.

31.  Fishwick D, D’Souza W, Beasley R. The asthma selfmanage

ment plan system of care: what does it mean, how is it done,
does it work, what models are available, what do patients want
and who needs it? Patient Educ Couns 1997;32(1 Suppl): 
S2133.

32.  Gibson PG, Powell H. Written action plans for asthma: an evi

dencebased review of the key components. Thorax
2004;59(2):949.

33.  Newman SP. Inhaler treatment options in COPD. Eur Respir Rev

2005;14(96):1028.

34.  Coutts JA, Gibson NA, Paton JY. Measuring compliance with

inhaled medication in asthma. Arch Dis Child 1992;67(3):3323.

35.  Franchi M, Carrer P. Indoor air quality in schools: the EFA pro

ject. Monaldi Arch Chest Dis 2002;57(2):1202.

36.  Arshad SH. Primary prevention of asthma and allergy. J Allergy

Clin Immunol 2005;116(1):314.

37.  Bousquet J, Yssel H, Vignola AM. Is allergic asthma associated

with delayed fetal maturation or the persistence of conserved
fetal genes? Allergy 2000;55(12):11947.

38.  Jones CA, Holloway JA, Warner JO. Does atopic disease start in

foetal life? Allergy 2000;55(1):210.

39.  Kramer MS. Maternal antigen avoidance during pregnancy for

preventing atopic disease in infants of women at high risk.
Cochrane Database Syst Rev 2000;2.

40.  Friedman NJ, Zeiger RS. The role of breastfeeding in the devel

opment of allergies and asthma. J Allergy Clin Immunol
2005;115(6):123848.

41.  Gdalevich M, Mimouni D, Mimouni M. Breastfeeding and the

risk of bronchial asthma in childhood: a systematic review with
metaanalysis of prospective studies. J Pediatr
2001;139(2):2616.

42.  Robinson DS, Larche M, Durham SR. Tregs and allergic disease.

J Clin Invest 2004;114(10):138997.

43.  Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S.

Probiotics: effects on immunity. Am J Clin Nutr 
2001;73(2 Suppl):444S50S.

44.  Ownby DR, Johnson CC, Peterson EL. Exposure to dogs and

cats in the first year of life and risk of allergic sensitization at 6 to
7 years of age. JAMA 2002;288(8):96372.

45.  Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M,

Morgan WJ. Asthma and wheezing in the first six years of life.
The Group Health Medical Associates. N Engl J Med
1995;332(3):1338.

46.  Dezateux C, Stocks J, Dundas I, Fletcher ME. Impaired airway

function and wheezing in infancy: the influence of maternal
smoking and a genetic predisposition to asthma. Am J Respir
Crit Care Med 1999;159(2):40310.

47.  Strachan DP, Cook DG. Health effects of passive smoking. 

5. Parental smoking and allergic sensitisation in children. Thorax
1998;53(2):11723.

48.  Strachan DP, Cook DG. Health effects of passive smoking. 

1. Parental smoking and lower respiratory illness in infancy and
early childhood. Thorax 1997;52(10):90514.

49.  Kulig M, Luck W, Lau S, Niggemann B, Bergmann R, Klettke U,

et al. Effect of pre and postnatal tobacco smoke exposure on
specific sensitization to food and inhalant allergens during the
first 3 years of life. Multicenter Allergy Study Group, Germany.
Allergy 1999;54(3):2208.

50.  Iikura Y, Naspitz CK, Mikawa H, Talaricoficho S, Baba M, Sole D,

et al. Prevention of asthma by ketotifen in infants with atopic
dermatitis. Ann Allergy 1992;68(3):2336.

51.  Allergic factors associated with the development of asthma and

the influence of cetirizine in a doubleblind, randomised, place
bocontrolled trial: first results of ETAC. Early Treatment of the
Atopic Child. Pediatr Allergy Immunol 1998;9(3):11624.

52.  Johnstone DE, Dutton A. The value of hyposensitization therapy

for bronchial asthma in children—a 14year study. Pediatrics
1968;42(5):793802.

53.  Moller C, Dreborg S, Ferdousi HA, Halken S, Host A, Jacobsen L,

et al. Pollen immunotherapy reduces the development of asthma
in children with seasonal rhinoconjunctivitis (the PATstudy). 
J Allergy Clin Immunol 2002;109(2):2516.

54.  Gotzsche PC, Hammarquist C, Burr M. House dust mite control

measures in the management of asthma: metaanalysis. BMJ
1998;317(7166):110510.

ПРОГРАММА ЛЕЧЕНИЯ И ПРОФИЛАКТИКИ БРОНХИАЛЬНОЙ АСТМЫ  93

55.  Gotzsche PC, Johansen HK, Schmidt LM, Burr ML. House dust

mite control measures for asthma. Cochrane Database Syst Rev
2004(4):CD001187.

56.  Sheffer AL. Allergen avoidance to reduce asthmarelated mor

bidity. N Engl J Med 2004;351(11):11346.

57.  PlattsMills TA. Allergen avoidance in the treatment of asthma

and rhinitis. N Engl J Med 2003;349(3):2078.

58.  Morgan WJ, Crain EF, Gruchalla RS, O’Connor GT, Kattan M,

Evans R, 3rd, et al. Results of a homebased environmental
intervention among urban children with asthma. N Engl J Med
2004;351(11):106880.

59.  PlattsMills TA, Thomas WR, Aalberse RC, Vervloet D,

Champman MD. Dust mite allergens and asthma: report of a
second international workshop. J Allergy Clin Immunol
1992;89(5):104660.

60.  Custovic A, Wijk RG. The effectiveness of measures to change

the indoor environment in the treatment of allergic rhinitis and
asthma: ARIA update (in collaboration with GA(2)LEN). Allergy
2005;60(9):11125.

61.  Luczynska C, Tredwell E, Smeeton N, Burney P. A randomized

controlled trial of mite allergenimpermeable bed covers in adult
mitesensitized asthmatics. Clin Exp Allergy 
2003;33(12):164853.

62.  Woodcock A, Forster L, Matthews E, Martin J, Letley L, 

Vickers M, et al. Control of exposure to mite allergen and aller
genimpermeable bed covers for adults with asthma. N Engl J
Med 2003;349(3):22536.

63.  Halken S, Host A, Niklassen U, Hansen LG, Nielsen F, 

Pedersen S, et al. Effect of mattress and pillow encasings on
children with asthma and house dust mite allergy. J Allergy Clin
Immunol 2003;111(1):16976.

64.  Custovic A, Green R, Taggart SC, Smith A, Pickering CA,

Chapman MD, et al. Domestic allergens in public places. II: Dog
(Can f1) and cockroach (Bla g 2) allergens in dust and mite, cat,
dog and cockroach allergens in the air in public buildings. Clin
Exp Allergy 1996;26(11):124652.

65.  Almqvist C, Larsson PH, Egmar AC, Hedren M, Malmberg P,

Wickman M. School as a risk environment for children allergic to
cats and a site for transfer of cat allergen to homes. J Allergy
Clin Immunol 1999;103(6):10127.

66.  Enberg RN, Shamie SM, McCullough J, Ownby DR. Ubiquitous

presence of cat allergen in catfree buildings: probable dispersal
from human clothing. Ann Allergy 1993;70(6):4714.

67.  Wood RA, Chapman MD, Adkinson NF, Jr., Eggleston PA. The

effect of cat removal on allergen content in householddust
samples. J Allergy Clin Immunol 1989;83(4):7304.

68.  Eggleston PA, Wood RA, Rand C, Nixon WJ, Chen PH, Lukk P.

Removal of cockroach allergen from innercity homes. J Allergy
Clin Immunol 1999;104(4 Pt 1):8426.

69.  Denning DW, O’Driscoll B R, Hogaboam CM, Bowyer P, 

Niven RM. The link between fungi and severe asthma: a summa
ry of the evidence. Eur Respir J 2006;27(3):61526.

70.  Hirsch T, Hering M, Burkner K, Hirsch D, Leupold W, 

Kerkmann ML, et al. Housedustmite allergen concentrations
(Der f 1) and mold spores in apartment bedrooms before and
after installation of insulated windows and central heating sys
tems. Allergy 2000;55(1):7983.

71.  Chaudhuri R, Livingston E, McMahon AD, Thomson L, 

Borland W, Thomson NC. Cigarette smoking impairs the thera
peutic response to oral corticosteroids in chronic asthma. Am J
Respir Crit Care Med 2003;168(11):130811.

72.  Chalmers GW, Macleod KJ, Little SA, Thomson LJ, McSharry CP,

Thomson NC. Influence of cigarette smoking on inhaled corti
costeroid treatment in mild asthma. Thorax 2002;57(3):22630.

73.  Upham JW, Holt PG. Environment and development of atopy.

Curr Opin Allergy Clin Immunol 2005;5(2):16772.

74.  Barnett AG, Williams GM, Schwartz J, Neller AH, Best TL,

Petroeschevsky AL, et al. Air pollution and child respiratory
health: a casecrossover study in Australia and New Zealand. 
Am J Respir Crit Care Med 2005;171(11):12728.

75.  Dales RE, Cakmak S, Judek S, Dann T, Coates F, Brook JR, et al.

Influence of outdoor aeroallergens on hospitalization for asthma
in Canada. J Allergy Clin Immunol 2004;113(2):3036.

76.  Anto JM, Soriano JB, Sunyer J, Rodrigo MJ, Morell F, Roca J,

et al. Long term outcome of soybean epidemic asthma after an
allergen reduction intervention. Thorax 1999;54(8):6704.

77.  Chen LL, Tager IB, Peden DB, Christian DL, Ferrando RE,

Welch BS, et al. Effect of ozone exposure on airway responses
to inhaled allergen in asthmatic subjects. Chest
2004;125(6):232835.

78.  Marks GB, Colquhoun JR, Girgis ST, Koski MH, Treloar AB,

Hansen P, et al. Thunderstorm outflows preceding epidemics of
asthma during spring and summer. Thorax 2001;56(6):46871.

79.  Newson R, Strachan D, Archibald E, Emberlin J, Hardaker P,

Collier C. Acute asthma epidemics, weather and pollen in
England, 19871994. Eur Respir J 1998;11(3):694701.

80.  Nicholson PJ, Cullinan P, Taylor AJ, Burge PS, Boyle C. Evidence

based guidelines for the prevention, identification, and manage
ment of occupational asthma. Occup Environ Med
2005;62(5):2909.

81.  Vandenplas O, Delwiche JP, Depelchin S, Sibille Y, Vande

Weyer R, Delaunois L. Latex gloves with a lower protein content
reduce bronchial reactions in subjects with occupational asthma
caused by latex. Am J Respir Crit Care Med 1995;151 (3 Pt 1):
88791.

82.  Hunt LW, BooneOrke JL, Fransway AF, Fremstad CE, Jones RT,

Swanson MC, et al. A medicalcenterwide, multidisciplinary
approach to the problem of natural rubber latex allergy. J Occup
Environ Med 1996;38(8):76570.

83.  Sicherer SH, Sampson HA. 9. Food allergy. J Allergy Clin

Immunol 2006;117(2 Suppl MiniPrimer):S4705.

84.  Roberts G, Patel N, LeviSchaffer F, Habibi P, Lack G. Food aller

gy as a risk factor for lifethreatening asthma in childhood: a
casecontrolled study. J Allergy Clin Immunol 
2003;112(1):16874.

85.  Taylor SL, Bush RK, Selner JC, Nordlee JA, Wiener MB,

Holden K, et al. Sensitivity to sulfited foods among sulfitesensi
tive subjects with asthma. J Allergy Clin Immunol
1988;81(6):115967.

86.  Szczeklik A, Nizankowska E, Bochenek G, Nagraba K, Mejza F,

Swierczynska M. Safety of a specific COX2 inhibitor in aspirin
induced asthma. Clin Exp Allergy 2001;31(2):21925.

87.  Covar RA, Macomber BA, Szefler SJ. Medications as asthma

triggers. Immunol Allergy Clin North Am 2005;25(1):16990.

88.  Nicholson KG, NguyenVanTam JS, Ahmed AH, Wiselka MJ,

Leese J, Ayres J, et al. Randomised placebocontrolled
crossover trial on effect of inactivated influenza vaccine on pul
monary function in asthma. Lancet 1998;351(9099):32631.

89.  Bueving HJ, Bernsen RM, de Jongste JC, van SuijlekomSmit LW,

Rimmelzwaan GF, Osterhaus AD, et al. Influenza vaccination in
children with asthma: randomized doubleblind placebocon
trolled trial. Am J Respir Crit Care Med 2004;169(4):48893.

90.  Cates CJ, Jefferson TO, Bara AI, Rowe BH. Vaccines for prevent

ing influenza in people with asthma. Cochrane Database Syst
Rev 2004(2):CD000364.

91.  The safety of inactivated influenza vaccine in adults and children

with asthma. N Engl J Med 2001;345(21):152936.

92.  Bergen R, Black S, Shinefield H, Lewis E, Ray P, Hansen J, et al.

Safety of coldadapted live attenuated influenza vaccine in a

94 ПРОГРАММА ЛЕЧЕНИЯ И ПРОФИЛАКТИКИ БРОНХИАЛЬНОЙ АСТМЫ

large cohort of children and adolescents. Pediatr Infect Dis J
2004;23(2):13844.

93.  Tantisira KG, Litonjua AA, Weiss ST, Fuhlbrigge AL. Association

of body mass with pulmonary function in the Childhood Asthma
Management Program (CAMP). Thorax 2003;58(12):103641.

94.  SteniusAarniala B, Poussa T, Kvarnstrom J, Gronlund EL,

Ylikahri M, Mustajoki P. Immediate and long term effects of
weight reduction in obese people with asthma: randomised con
trolled study. BMJ 2000;320(7238):82732.

95.  Rietveld S, van Beest I, Everaerd W. Stressinduced breathless

ness in asthma. Psychol Med 1999;29(6):135966.

96.  Sandberg S, Paton JY, Ahola S, McCann DC, McGuinness D,

Hillary CR, et al. The role of acute and chronic stress in asthma
attacks in children. Lancet 2000;356(9234):9827.

97.  Lehrer PM, Isenberg S, Hochron SM. Asthma and emotion: a

review. J Asthma 1993;30(1):521.

98.  Nouwen A, Freeston MH, Labbe R, Boulet LP. Psychological fac

tors associated with emergency room visits among asthmatic
patients. Behav Modif 1999;23(2):21733.

99.  Rachelefsky GS, Katz RM, Siegel SC. Chronic sinus disease with

associated reactive airway disease in children. Pediatrics
1984;73(4):5269.

100. Harding SM, Guzzo MR, Richter JE. The prevalence of gastroe

sophageal reflux in asthma patients without reflux symptoms.
Am J Respir Crit Care Med 2000;162(1):349.

101. Patterson PE, Harding SM. Gastroesophageal reflux disorders

and asthma. Curr Opin Pulm Med 1999;5(1):637.

102. Chien S, Mintz S. Pregnancy and menses. In: Weiss EB, Stein M,

eds. Bronchial asthma Mechanisms and therapeutics. Boston:
Little Brown; 1993:p. 108598.

103. Barron WM, Leff AR. Asthma in pregnancy. Am Rev Respir Dis

1993;147(3):5101.

104. Bateman ED, Boushey HA, Bousquet J, Busse WW, Clark TJ,

Pauwels RA, et al. Can guidelinedefined asthma control be
achieved? The Gaining Optimal Asthma ControL study. Am J
Respir Crit Care Med 2004;170(8):83644.

105. Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P,

et al. Development of the asthma control test: a survey for
assessing asthma control. J Allergy Clin Immunol
2004;113(1):5965.

106. Juniper EF, Buist AS, Cox FM, Ferrie PJ, King DR. Validation of a

standardized version of the Asthma Quality of Life Questionnaire.
Chest 1999;115(5):126570.

107. Juniper EF, Bousquet J, Abetz L, Bateman ED. Identifying ‘well

controlled’ and ‘not wellcontrolled’ asthma using the Asthma
Control Questionnaire. Respir Med 2005.

108. Juniper EF, Svensson K, Mork AC, Stahl E. Measurement prop

erties and interpretation of three shortened versions of the asth
ma control questionnaire. Respir Med 2005;99(5):5538.

109. Vollmer WM, Markson LE, O’Connor E, Sanocki LL, Fitterman L,

Berger M, et al. Association of asthma control with health care
utilization and quality of life. Am J Respir Crit Care Med
1999;160(5 Pt 1):164752.

110. Boulet LP, Boulet V, Milot J. How should we quantify asthma

control? A proposal. Chest 2002;122(6):221723.

111. O’Byrne PM, Barnes PJ, RodriguezRoisin R, Runnerstrom E,

Sandstrom T, Svensson K, et al. Low dose inhaled budesonide
and formoterol in mild persistent asthma: the OPTIMA random
ized trial. Am J Respir Crit Care Med 2001;164(8 Pt 1):13927.

112. Pauwels RA, Pedersen S, Busse WW, Tan WC, Chen YZ, 

Ohlsson SV, et al. Early intervention with budesonide in mild per
sistent asthma: a randomised, doubleblind trial. Lancet
2003;361(9363):10716.

113. Zeiger RS, Baker JW, Kaplan MS, Pearlman DS, Schatz M,

Bird S, et al. Variability of symptoms in mild persistent asthma:
baseline data from the MIAMI study. Respir Med
2004;98(9):898905.

114. Using beta 2stimulants in asthma. Drug Ther Bull 

1997;35(1):14.

115. Godfrey S, BarYishay E. Exercisedinduced asthma revisited.

Respir Med 1993;87(5):33144.

116. Leff JA, Busse WW, Pearlman D, Bronsky EA, Kemp J, 

Hendeles L, et al. Montelukast, a leukotrienereceptor antago
nist, for the treatment of mild asthma and exerciseinduced
bronchoconstriction. N Engl J Med 1998;339(3):14752.

117. Spooner CH, Saunders LD, Rowe BH. Nedocromil sodium for

preventing exerciseinduced bronchoconstriction. Cochrane
Database Syst Rev 2000;2.

118. Reiff DB, Choudry NB, Pride NB, Ind PW. The effect of pro

longed submaximal warmup exercise on exerciseinduced asth
ma. Am Rev Respir Dis 1989;139(2):47984.

119. Ram FS, Robinson SM, Black PN. Physical training for asthma.

Cochrane Database Syst Rev 2000;2.

120. Adams NP, Bestall JB, Malouf R, Lasserson TJ, Jones PW.

Inhaled beclomethasone versus placebo for chronic asthma.
Cochrane Database Syst Rev 2005(1):CD002738.

121. Drazen JM, Israel E, O’Byrne PM. Treatment of asthma with

drugs modifying the leukotriene pathway. N Engl J Med
1999;340(3):197206.

122. Barnes NC, Miller CJ. Effect of leukotriene receptor antagonist

therapy on the risk of asthma exacerbations in patients with mild
to moderate asthma: an integrated analysis of zafirlukast trials.
Thorax 2000;55(6):47883.

123. Bleecker ER, Welch MJ, Weinstein SF, Kalberg C, Johnson M,

Edwards L, et al. Lowdose inhaled fluticasone propionate ver
sus oral zafirlukast in the treatment of persistent asthma.
J Allergy Clin Immunol 2000;105(6 Pt 1):11239.

124. Wilson AM, Dempsey OJ, Sims EJ, Lipworth BJ. A comparison of

topical budesonide and oral montelukast in seasonal allergic
rhinitis and asthma. Clin Exp Allergy 2001;31(4):61624.

125. Philip G, Nayak AS, Berger WE, Leynadier F, Vrijens F, Dass SB,

et al. The effect of montelukast on rhinitis symptoms in patients
with asthma and seasonal allergic rhinitis. Curr Med Res Opin
2004;20(10):154958.

126. Dahl R, Larsen BB, Venge P. Effect of longterm treatment with

inhaled budesonide or theophylline on lung function, airway
reactivity and asthma symptoms. Respir Med 2002;96(6):4328.

127. Kidney J, Dominguez M, Taylor PM, Rose M, Chung KF,

Barnes PJ. Immunomodulation by theophylline in asthma.
Demonstration by withdrawal of therapy. Am J Respir Crit Care
Med 1995;151(6):190714.

128. Sullivan P, Bekir S, Jaffar Z, Page C, Jeffery P, Costello J. Anti

inflammatory effects of lowdose oral theophylline in atopic
asthma. Lancet 1994;343(8904):10068.

129. Evans DJ, Taylor DA, Zetterstrom O, Chung KF, O’Connor BJ,

Barnes PJ. A comparison of lowdose inhaled budesonide plus
theophylline and highdose inhaled budesonide for moderate
asthma. N Engl J Med 1997;337(20):14128.

130. Rivington RN, Boulet LP, Cote J, Kreisman H, Small DI,

Alexander M, et al. Efficacy of Uniphyl, salbutamol, and their
combination in asthmatic patients on highdose inhaled steroids.
Am J Respir Crit Care Med 1995;151(2 Pt 1):32532.

131. Tsiu SJ, Self TH, Burns R. Theophylline toxicity: update. Ann

Allergy 1990;64(2 Pt 2):24157.

132. Ellis EF. Theophylline toxicity. J Allergy Clin Immunol 1985;76 

(2 Pt 2):297301.

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