Montelukast use during pregnancy: a multicentre, prospective, comparative study of infant outcomes
Moumita SarkarGideon KorenSanjog KalraAngela Yating YingC SmorlesiMarco De SantisOrna Diav‐CitrinMeytal AvgilSharon Voyer LavigneMatti BerkovichAdrienne Einarson
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Montelukast is a leukotriene receptor antagonist that is used to treat allergy and asthma. It acts as a cysteinyl leukotriene receptor antagonist that blocks the action of leukotrienes and decreases inflammation. This agent is generally well tolerated in clinical practice. Although montelukast is generally considered as a safe drug, it can cause a few adverse drug reactions. In this case study, a rare side effect of montelukast that has been reported only twice before is presented. The importance of this case report is that the youngest patient who had ecchymosis due to the use of montelukast treatment is reported
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(1) Montelukast, an antiasthmatic drug belonging to the leukotriene antagonist family, has two indications in France: as adjunctive treatment for mild to moderate chronic asthma when regular inhaled steroid therapy and short-acting inhaled beta 2 stimulants "on demand" are inadequate; and in the prevention of effort-induced asthma. (2) The clinical file on montelukast contains no methodologically acceptable comparisons with reference treatments. (3) Several placebo-controlled trials have shown the efficacy of montelukast, with an improvement in clinical scores and respiratory function tests in chronic asthma; and prevention of effort-induced asthma. (4) In chronic asthma montelukast has not been compared with oral or inhaled long-acting beta 2 stimulants, or with sustained-release theophylline in patients inadequately controlled by steroid therapy. (5) In effort-induced asthma, only two trials have compared montelukast to salmeterol. On the basis of preliminary results the authors concluded that montelukast was superior in both studies. (6) Clinical trials showed no clear difference in the frequency of side effects in patients on montelukast and those on a placebo. However, montelukast may possibly be associated with the Churg and Strauss syndrome in rare cases. (7) Montelukast is an expensive drug.
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Objective To study the curative effect of Montelukast in bronchiolitis and to evaluate the efficiency of montelukast in decreasing the incidence of asthma following brochiolitis.Methods 90 cases bronchiolitis were categorized in two groups,therapy group 45 cases and control group 45 cases,conventional Medical treatment were given in two groups,Montelukast was appendant in therapy group,4mg,qn,4 weeks.The time of follow up was over 1 year.Results The cure rate of therapy group was significant higher than control group(P0.01),the difference had statistical value.Incidence of asthma following brochiolitis with montelukast was less than without montelukast.Conclusion Montelukast can conspicuous increase the therapy effects of bronchiolitis,Montelukast is an effective way to decrease the incidence of asthma following brochiolitis.Using Montelukast is a good way to precaut the asthma following brochiolitis,and it is not adverse reactions.
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Introduction Montelukast is a leukotrienes receptor antagonist, which is used, in chronic asthma, exercise induced broncoconstriction and allergic rhinitis treatment. Montelukast inhibates the proinflammatory cytokines and leukotriene is released from the specific cells. Leukotrienes cause mucus secretion, vasodilatation, broncoconstriction and eosinophilia. This case is about an asthma-diagnosed child who had acute disturbing behaviour and sleeping problems after using montelukast treatment. Case A 5 year-old boy assessed because of symptoms like breaking the rules, disturbing friends, self-harming, hyperactivity, distractability, insomnia and nightmares. In his history, when he was 9months old acute hyperactivity, yelling, naughtiness, insomnia, disturbing and self-harming behaviours occurred suddenly 24hours after intravenous montelukast treatment due to asthma crisis. While he was still using oral montelukast, his parents had cut off the treatment. After about 2months, there was decrease in the symptoms. After using montelukast, these kinds of misbehaviour occurred again in a week. The montelukast treatment was terminated controlled way under a pediatrician consultation. Turgay DSM-IV Based Distruptive Behaviour Disorders Screening and Rating Scale were completed by both of the parents in the first interview and after 2months of cutting off montelukast treatment. While comparing 2 scales and parents' anamnesis, we found that impulsivity, oppositional defiant, hyperactivity, distractability, breaking off the rules, irritability, insomnia and having nightmares reduced. Conclusion Montelukast can cause many psychiatric symptoms. In that case we found sleeping problems and disturbing behaviour caused or induced by montelukast treatment. As in that case, other drugs also can cause or enhance psychiatric symptoms. So it is important to assess the other drugs while assessing the diagnosis and the treatment.
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Montelukast (Singulair), an antiasthma drug belonging to the leukotriene antagonist family, has two indications: as adjunctive treatment for mild-to-moderate chronic asthma when regular inhaled steroid therapy and short-acting inhaled beta2 stimulants "on demand" are inadequate; and in prevention of effort-induced asthma. The clinical file on montelukast contains no methodologically acceptable comparisons with reference treatments. Several placebo-controlled trials have shown the efficacy of montelukast, with improvement in clinical scores and respiratory function tests in those with chronic asthma and prevention of effort-induced asthma. For chronic asthma, montelukast has not been compared with oral or inhaled long-acting beta2 stimulants or with sustained-release theophylline in patients inadequately controlled by steroid therapy. For effort-induced asthma, only two trials have compared montelukast with salmeterol. On the basis of preliminary results, the authors of both studies concluded that montelukast was superior. Clinical trials showed no clear difference in the frequency of side effects in patients taking montelukast and patients taking placebo. Montelukast, however, might be associated with Churg-Strauss syndrome in rare cases. Montelukast is expensive.
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Montelukast is a leukotriene receptor antagonist that is effective in the treatment of allergic rhinitis and asthma. We report a rare case of a 31-year-old woman with a history of allergic rhinitis and moderate persistent asthma, who experienced severe bruising on her lower extremities after starting montelukast treatment. Clinicians should be aware of the possibility of unusual bruising during montelukast therapy, and in those patients montelukast should be discontinued.
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From involvement in the first trial of montelukast in children in Australia, the author has noted significant change in asthma management. The Australian Asthma Handbook (AAH) (last updated October 2016) currently recommends montelukast as first-line therapy for children aged 2–5 years with frequent intermittent asthma or episodic viral wheeze (EVW) with frequent symptoms.1 AAH suggests a 2-to-4-week trial of montelukast, and if the response is inadequate, for escalation to daily inhaled corticosteroids (ICS) for a minimum 4-week period. A recent Cochrane review2 found that there was no evidence for maintenance or intermittent montelukast in pre-school children with EVW. A recent meta-analysis agreed with these findings,3 noting the positive effect of intermittent administration of ICS for these children. Previously, an Australian study found a reduction in acute unscheduled medical presentations for those randomised to montelukast compared to placebo.4 Further studies are required to better elucidate the role of montelukast in managing EVW.
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Introduction: Montelukast has been used for asthma treatment. Recently, montelukast-L is produced locally in Thailand. Therefore, it is important to determine the effi cacy of the local drug in terms of mediator inhibition. Objective: Effects of montelukast-I and montelukast-L on cysteinyl leukotriene (CysLT) production were investigated. Materials and Methods: The cytotoxicity of montelukast-I and montelukast-L on RBL-2H3 cells was determined using MTT assay. To compare the pharmacological properties between montelukast-I and montelukast-L, effects of two drugs on rat mast cells (RBL-2H3) cells was monitored by measuring the CysLT released. RBL-2H3 cells were sensitized with anti-dinitrophenyl (DNP)-specifi c IgE for 30 min. Then, cells were treated with the test drugs at the concentrations of 0, 5, 10, 50 and 75 μM for 1 h, followed by the addition of DNP-BSA (10 μg/ml) for 30 min. The total CysLT released in condition media was determined using a leukotriene enzyme immunoassay kit (Amersham). Results: There was no any cytotoxicity when mast cells were treated with montelukast-I or montelukast-L (5-50 μM). Both drugs could significantly inhibit the release of CysLT compared to that of the control. There was no statistically signifi cant difference between montelukast-I and montelukast-L (25-50 μM) in CysLT inhibition. However, montelukast-I at 5-10 μM obviously suppressed CysLT released from mast cells compared to that of montelukast-L. Conclusion: Our fi ndings suggest that montelukast-I at low concentrations have a high potential for inhibition of CysLT released from mast cells. Key words: Asthma, Montelukast-I (Innovator), Montelukast-L (Local), Cysteinyl leukotriene,rat mast cells (RBL-2H3)
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