LEUKOTRIENE ANTAGONISTS; CROMOLYN & NEDOCROMIL
A leukotriene receptor antagonist taken as an oral tablet may be considered as an alternative to inhaled corticosteroid treatment in patients with symptoms occurring more than twice a week or those who are awakened from sleep by asthma more than twice a month. This place in asthma therapy was once held by cromolyn and nedo-cromil, but neither is now available in the USA. Although thesetreatments are not as effective as even a low dose of an inhaled corticosteroid, both avoid the issue of “steroid phobia” described above and are commonly used in the treatment of children.
The leukotriene receptor antagonist montelukast (Singulair) is widely prescribed, especially by primary care providers. This drug, taken orally, is easy to administer and appears to be used more regularly than inhaled corticosteroids. Leukotriene receptor antag-onists are rarely associated with troublesome side effects. Because of concerns over the possible long-term toxicity of systemic absorption of inhaled corticosteroids, this maintenance therapy is widely used for treating children in the USA.