The following should be avoided in asthma patient-
Correct Answer: NSAID
Description: Ans. is 'a' i.e., NSAID o NSAID ingestion precipitate a constellation of naso-ocular and or lower respiratory symptoms in some patients with concomitant asthma and chronic rhinosinusitis (often with nasal polyposis).o These symptoms include one or more of the following: -RhinorrhoeaNasal congestionPeriorbital edemannjection of the conjunctivaBronchospasmLaryngospasmHives and/or angioedemao Patients with combination ofNS AID pseudoallergy asthma, and chronic rhinosinusitis with nasal polyposis are said to have aspirin exacerbated respiratory disease (AERD).o The ingestion of NS A IDS can give rise to two ty-pes of reaction i.e., allergic and pseudoallergic reactions which develops within minutes to hours of administration.# Allergic reactions are abnormal immunological reactions to NS A IDs while pseudoallergic reactions are nonimmunological reactions that are believed to result from acquired alterations in the biochemical pathways upon which NSA1DS act.Pseudoallergic NSAID reactionso Pseudoallergic reactions are nonimmunologic reactions that are related to the c>cloox>genase (COX)-1 inhibiting properties of the drug.o In susceptible individuals, these reactions may be elicited by any NSAID that inhibits COX-l, including aspirin (ASA) .o Affected patients are believed to have acquired alterations in the biochemical pathways affected by COX-1-inhibitors, although the precise mechanism underlying pseudoallergic reactions has not been established.Allergic NSAID reactionso Allergic NSAID reactions are presumed to be IgE-mediated immunologic reactions based upon their clinical characteristics. These are elicited by a single NSAID in a susceptible individual.NSAID ReactionsPseudoallergicAllergico NSAID-induced asthma and rhinosinusitiso Urticaria/angioedema to a single NSAIDo NSAID-induced urticaria/angioedema ino Anaphylaxis to a single NSAID (not ASA)patients with chronic urticarial o NSAID-induced urticaria/angioedema in otherwise asymptomatic individuals o Blended (mixed respiratory and/or cutaneous) reactions in otherwise asymptomatic individuals
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