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Acetaminophen and asthma

Teeranai Sakulchit, Ran D Goldman
Question A child with a history of asthma came to my clinic with acute fever. I have heard that acetaminophen might be associated with exacerbation of asthma. Is it safe if I recommend acetaminophen for this child? Answer Most studies suggest an association between acetaminophen use in children and development of asthma later in childhood. However, several confounding factors in study design might contribute to this positive correlation, and without a prospective controlled trial, confirming this finding is challenging...
March 2017: Canadian Family Physician Médecin de Famille Canadien
Avraham Beigelman, Leonard B Bacharier
PURPOSE OF REVIEW: The purpose of this review is to summarize the recent evidence on the management of preschool children with wheezing and asthma, and to propose a phenotype-based approach to the management of these children. RECENT FINDINGS: Recent studies have begun to identify populations of preschool children that are likely to benefit from inhaled corticosteroids (ICS) therapy and defined ICS regimens: daily ICS in preschool children with persistent asthma, and pre-emptive high-dose intermittent ICS among preschool children with intermittent disease reduce the risk of exacerbation...
April 2017: Current Opinion in Allergy and Clinical Immunology
Christian Rosas-Salazar, Tina V Hartert
PURPOSE OF REVIEW: To critically evaluate and summarize studies published between July 2015 and June 2016 linking prenatal exposures and the onset of childhood wheezing illnesses and to discuss future research directions in this field. RECENT FINDINGS: The aggregated evidence indicates a consistent detrimental effect of prenatal exposure to parental smoking, outdoor air pollution, and maternal stress on childhood wheezing illnesses. Less consistent evidence suggests an adverse impact of maternal obesity during pregnancy and prenatal exposure to antibiotics on these outcomes...
January 11, 2017: Current Opinion in Allergy and Clinical Immunology
Chika E Uzoigwe, Omer H Ali
No abstract text is available yet for this article.
November 24, 2016: New England Journal of Medicine
William J Sheehan, Wanda Phipatanakul
No abstract text is available yet for this article.
November 24, 2016: New England Journal of Medicine
Ilan Matok, Arnon Elizur, Amichai Perlman, Shani Ganor, Hagai Levine, Eran Kozer
BACKGROUND: Many infants and children receive acetaminophen and/or ibuprofen during febrile illness. Previously, some studies have linked acetaminophen and ibuprofen use to wheezing and exacerbation of asthma symptoms in infants and children. OBJECTIVE: To assess whether acetaminophen or ibuprofen use are associated with wheezing in children presenting to the emergency department (ED) with febrile illness. METHODS: This was a cross-sectional study of children who presented with fever to the pediatric ED between 2009 and 2013...
October 27, 2016: Annals of Pharmacotherapy
Tamara Lourido-Cebreiro, Francisco-Javier Salgado, Luis Valdes, Francisco-Javier Gonzalez-Barcala
OBJECTIVE: To analyse the relationship between paracetamol and asthma. DATA SOURCES: An English literature search using electronic search engines (PubMed and EMBASE) was conducted. STUDY SELECTIONS: Articles published in peer-review journals, from 1990 to December 2015 were included. To perform the search for the most suitable and representative articles, keywords were selected ("asthma," "paracetamol" and "acetaminophen"). The evidence level was rated according to the criteria of the Oxford Centre For Evidence-Based Medicine...
January 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Augusto A Litonjua
No abstract text is available yet for this article.
August 18, 2016: New England Journal of Medicine
William J Sheehan, David T Mauger, Ian M Paul, James N Moy, Susan J Boehmer, Stanley J Szefler, Anne M Fitzpatrick, Daniel J Jackson, Leonard B Bacharier, Michael D Cabana, Ronina Covar, Fernando Holguin, Robert F Lemanske, Fernando D Martinez, Jacqueline A Pongracic, Avraham Beigelman, Sachin N Baxi, Mindy Benson, Kathryn Blake, James F Chmiel, Cori L Daines, Michael O Daines, Jonathan M Gaffin, Deborah A Gentile, W Adam Gower, Elliot Israel, Harsha V Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Ngoc Ly, Jyothi Marbin, Wayne J Morgan, Ross E Myers, J Tod Olin, Stephen P Peters, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Shannon M Thyne, Michael E Wechsler, Wanda Phipatanakul
BACKGROUND: Studies have suggested an association between frequent acetaminophen use and asthma-related complications among children, leading some physicians to recommend that acetaminophen be avoided in children with asthma; however, appropriately designed trials evaluating this association in children are lacking. METHODS: In a multicenter, prospective, randomized, double-blind, parallel-group trial, we enrolled 300 children (age range, 12 to 59 months) with mild persistent asthma and assigned them to receive either acetaminophen or ibuprofen when needed for the alleviation of fever or pain over the course of 48 weeks...
August 18, 2016: New England Journal of Medicine
Kendra Sih, Ran D Goldman
QUESTION: A child in my clinic who recently sprained his ankle is experiencing pain and having trouble bearing weight on the affected leg. His mother has been giving him acetaminophen, as she was told never to use nonsteroidal anti-inflammatory drugs (NSAIDs) because of his pharmacologically controlled asthma. Is asthma in children a contraindication to giving NSAIDs? Is NSAID-exacerbated respiratory disease (NERD) a real entity? ANSWER: Nonsteroidal anti-inflammatory drugs are effective analgesic and antipyretic medications...
August 2016: Canadian Family Physician Médecin de Famille Canadien
Gregory J Smith, Roger S Thrall, Michelle M Cloutier, Jose E Manautou, John B Morris
Epidemiologic evidence suggests that N-acetyl-para-aminophenol (APAP) may play a role in the pathogenesis of asthma, likely through pro-oxidant mechanisms. However, no studies have investigated the direct effects of APAP on the development of allergic inflammation. To determine the likelihood of a causal relationship between APAP and asthma pathogenesis, we explored the effects of APAP on inflammatory responses in a murine house dust mite (HDM) model of allergic airway disease. We hypothesized that APAP would enhance the development of HDM-induced allergic inflammation...
September 2016: Journal of Pharmacology and Experimental Therapeutics
H Hoeke, S Roeder, A Mueller, T Bertsche, M Borte, U Rolle-Kampczyk, M von Bergen, D K Wissenbach
An association between prenatal acetaminophen or ibuprofen intake and an increased risk of asthma and increased IgE level in children is discussed in various epidemiological studies. Although the molecular mechanistic link is still unknown, the question whether or not acetaminophen and/or ibuprofen are safe pain medications during pregnancy arose. In this study, we associate maternal acetaminophen and ibuprofen intake during pregnancy and breastfeeding to infantile asthma phenotypes and elevated IgE level. Therefore, we analysed questionnaires from a local mother-child cohort and monitored drug intake by LC-MS biomonitoring in urine...
June 2016: Allergy
David Price, Andrew M Wilson, Alison Chisholm, Anna Rigazio, Anne Burden, Michael Thomas, Christine King
PURPOSE: Acute, severe asthma exacerbations can be difficult to predict and thus prevent. Patients who have frequent exacerbations are of particular concern. Practical exacerbation predictors are needed for these patients in the primary-care setting. PATIENTS AND METHODS: Medical records of 130,547 asthma patients aged 12-80 years from the UK Optimum Patient Care Research Database and Clinical Practice Research Datalink, 1990-2013, were examined for 1 year before (baseline) and 1 year after (outcome) their most recent blood eosinophil count...
2016: Journal of Asthma and Allergy
Augusto Peñaranda, Elizabeth Garcia, Ana M Barragán, Martín A Rondón, Adriana Pérez, María X Rojas, Luis Caraballo, Rodolfo J Dennis
BACKGROUND: Several studies have shown variations in the prevalence of allergic rhinitis (AR) around the world, and different potential predisposing factors. More studies are needed on risk factors, specifically in developing countries. This study explored the association of several factors and AR among urban residents in six cities of Colombia. METHODOLOGY: A cross-sectional study and a nested case-control study were carried out between 2009 and 2010 involving two Colombian subpopulations: children/adolescents and adults...
March 2016: Rhinology
Kristin Thiele, M Emilia Solano, Samuel Huber, Richard A Flavell, Timo Kessler, Roja Barikbin, Roman Jung, Khalil Karimi, Gisa Tiegs, Petra C Arck
Acetaminophen (APAP; ie, Paracetamol or Tylenol) is generally self-medicated to treat fever or pain and recommended to pregnant women by their physicians. Recent epidemiological studies reveal an association between prenatal APAP use and an increased risk for asthma. Our aim was to identify the effects of APAP in pregnancy using a mouse model. Allogeneically mated C57Bl/6J females were injected i.p. with 50 or 250 mg/kg APAP or phosphate-buffered saline on gestation day 12.5; nonpregnant females served as controls...
October 2015: American Journal of Pathology
C B Ching, S R Hays, T R Luckett, M D Mason, D B Clayton, S T Tanaka, J C Thomas, M C Adams, J W Brock, J C Pope
INTRODUCTION: Idiopathic testicular/groin pain can be a difficult entity for children, their families, and caregivers. The role of interdisciplinary pain management has previously been demonstrated in treating chronic orchialgia at the present pediatric pain clinic. OBJECTIVE: To evaluate the role of interdisciplinary pain management in managing refractory orchialgia. It was hypothesized that children with refractory orchialgia might respond well. Interdisciplinary care was defined as that which crosses two medical disciplines such as a surgical specialty and specialist in analgesia...
June 2015: Journal of Pediatric Urology
Sally J Ioannides, Robert Siebers, Kyle Perrin, Mark Weatherall, Julian Crane, Justin Travers, Philippa Shirtcliffe, Richard Beasley
OBJECTIVE: Acetaminophen is often used on a regular, daily basis for the treatment of chronic pain; however, the safety of regular acetaminophen is still debated. This study determined whether 12 weeks of treatment with acetaminophen at half the maximum recommended daily dose causes an increase in alanine transaminase (ALT) in healthy adults participating in a clinical trial of the effect of acetaminophen on asthma control and severity. DESIGN AND METHODS: 94 healthy adults aged 18-65 years with mild to moderate asthma and with no history of previous liver dysfunction and an ALT within 1...
July 2015: Clinical Biochemistry
Debbie C P Lee, Simone A Walker, Adam J Byrne, Lisa G Gregory, James Buckley, Andrew Bush, Seif O Shaheen, Sejal Saglani, Clare M Lloyd
BACKGROUND: Current data concerning maternal paracetamol intake during pregnancy, or intake during infancy and risk of wheezing or asthma in childhood is inconclusive based on epidemiological studies. We have investigated whether there is a causal link between maternal paracetamol intake during pregnancy and lactation and the development of house dust mite (HDM) induced allergic airways disease (AAD) in offspring using a neonatal mouse model. METHODS: Pregnant mice were administered paracetamol or saline by oral gavage from the day of mating throughout pregnancy and/or lactation...
June 2015: Thorax
Khalil Karimi, Timo Keßler, Kristin Thiele, Katherina Ramisch, Annette Erhardt, Peter Huebener, Roja Barikbin, Petra Arck, Gisa Tiegs
BACKGROUND & AIMS: During pregnancy, acetaminophen is one of the very few medications recommended by physicians to treat fever or pain. Recent insights from epidemiological studies suggest an association between prenatal acetaminophen medication and an increased risk for development of asthma in children later in life. The underlying pathogenesis of such association is still unknown. METHODS: We aimed to develop a mouse model to provide insights into the effect of prenatal acetaminophen on maternal, fetal and adult offspring's health...
May 2015: Journal of Hepatology
Barbara Osimani, Fiorenzo Mignini
It is increasingly acknowledged both among epidemiologists and regulators that the assessment of pharmaceutical harm requires specific methodological approaches that cannot simply duplicate those developed for testing efficacy. However, this intuition lacks sound epistemic bases and delivers ad hoc advice. This paper explains why the same methods of scientific inference do not fare equally well for efficacy and safety assessment by tracing them back to their epistemic foundations. To illustrate this, Cartwright's distinction into clinching and vouching methods is adopted and a series of reasons is provided for preferring the latter to the former: (1) the need to take into account all available knowledge and integrate it with incoming data; (2) the awareness that a latent unknown risk may always change the safety profile of a given drug (precautionary principle); (3) cumulative learning over time; (4) requirement of probabilistic causal assessment to allow decision under uncertainty; (5) impartiality; and (6) limited and local information provided by randomised controlled trials...
January 2015: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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