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Rhinology and Facial Plastics
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Adnan Darr, Karan Jolly, Shahzada Ahmed, Claire Hopkins
History: Nasal congestion, rhinorrhea, anosmia, facial painDuration, progression, laterality and severity of symptomsAllergic historySamters triad for AERD: Aspirin sensitivity, polyps, asthmaRed flags: Bleeding, facial numbness, visual symptoms
Nonopioid and Adjuvant Analgesic Agents
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
AERD refers to the onset of bronchospasm following the administration of aspirin and other nsNSAIDs in some patients with asthma (Schug et al, 2020). Up to 10–15% of adult asthmatic patients have AERD, and these medicines should therefore be used with caution in patients with asthma. It is worth asking asthmatic patients whether they have taken nsNSAIDs before, as many will have done so without any worsening of their symptoms.
Drug Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Aspirin Exacerbated Respiratory Disease (AERD) is a chronic condition with four related symptoms: asthma, nasal polyposis with rhinosinusitis and acute respiratory exacerbations with exposure to aspirin or other NSAIDs (Namazy et al. 2002). AERD is an acquired imbalance of arachidonic acid metabolism and altered sensitivity to the downstream lipid mediators of this pathway. All COX-1 inhibitors, including aspirin and other NSAIDs, lead to increased production of proinflammatory cysteinyl leukotrienes and decreased synthesis of anti-inflammatory prostaglandin E2, exacerbating inflammation of the respiratory tract and causing bronchospasm.
Asthma pharmacotherapy: an update on leukotriene treatments
Published in Expert Review of Respiratory Medicine, 2019
Hoang Kim Tu Trinh, So-Hee Lee, Thi Bich Tra Cao, Hae-Sim Park
AERD is characterized by chronic rhinitis and asthma triggered by aspirin and other nonsteroidal anti-inflammatory drugs [70]. The prevalence of AERD is reported at 7%-10% among adult asthmatics; 10%-15% among severe asthmatics [71]. Main pathogenic mechanisms are driven by overproduction of LTs and eosinophil activation. Several studies demonstrated that LTRAs are beneficial for improving upper airway symptoms as well as asthma symptoms. A randomized, double-blind, placebo-controlled, crossover study showed beneficial effects of LTRA on upper airway symptoms in patients with AERD [70]. Another randomized, placebo-controlled study demonstrated beneficial add-on effects of LTRA on ICS in AERD patients in the aspects of symptom controls, predicted values of FEV1 (%) and quality of life [72].
Depression symptoms and quality of life among individuals with aspirin-exacerbated respiratory disease
Published in Journal of Asthma, 2019
Jonathan M. Feldman, Ariel E. Zeigler, Krista Nelson, Esperanza Morales-Raveendran, Teresa Pelletier, Gigia Roizen, Zhen Ren, Elina Jerschow
Aspirin-exacerbated respiratory disease (AERD) is a chronic medical condition and an important phenotype of asthma and sinus disease [1, 2]. AERD is characterized by three main factors which include (1) adult-onset asthma, (2) nasal polyps and (3) respiratory reactions to aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) [2, 3], also known as Samter’s triad [4]. For patients with AERD, exposure to NSAIDs produces a hypersensitivity reaction, similar to an asthma or rhinitis attack [5]. It is common for certain symptoms such as chronic congestion and nasal polyps to develop years preceding a diagnosis [6], ultimately leading to the onset of AERD. In addition to the uncomfortable presence of nasal polyps, asthma in patients with AERD typically presents as severe, persistent and difficult-to-treat [1, 5]. The prevalence of AERD in adults with asthma is approximately 7% overall, although this rate increases to 15% among patients with severe asthma [7]. African–Americans appear to be at increased risk for AERD [8].
Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery
Published in Acta Oto-Laryngologica, 2019
Aleksandar Perić, Sandra Vezmar Kovačević, Aleksandra Barać, Dejan Gaćeša, Aneta V. Perić, Svjetlana Matković Jožin
Sixty-two patients (n = 62) with diagnosis of AERD were involved to enter the study. Three (n = 3) refused to participate and twenty-nine (n = 29) patients not meeting inclusion criteria. Thirty (n = 30) patients, operated by the same surgical technique were thus recruited and assigned to Group 1 (n = 15) and Group 2 (n = 15). In total, 30 adult patients (17 males and 13 females, aged from 26 to 62 years) with diagnosis of CRSwNP associated with aspirin sensitivity were included in this study. There was no statistically significant difference in age and gender, preoperative nasal symptom score, endoscopic score and Lund–Mackay CT score between groups. The baseline characteristics are presented in Table 1.