| [ Summary ] |
Therapy for patients with bronchial asthma has changed from beta-stilmulants and theophyline to the inhalaltion of adrenocorticoids. Theophyline should be used for moderate asthma-attacks. The concentration of theophyline should be kept between 5 and 18 micro g/ml through therapeutic drug monitoring (TDM). Dialysis patients, being compromised hosts, have a tendency toward pulmonary infection, due to Gram-negative bacteria and methicilline-resistant Staphylococcus aureus (MRSA). Aminoglycoside has broad spectrum. Treatment levels of aminoglycosides are from 4 to 15 micro g/ml. Treatment concentrations of vancomycin at peak levels varies from 2O to 40 micro g/ml, and from 5 to 10 micro g/ml at trough levels. Macrolides play a role not only as antibiotics, but also as immune-modulators, especially for patients with diffuse pan-bronchitis (DPB). Neutrophil elastase-inhibitors are effective in cases of acute pulmonary injury, systemic inflammatory responses, and idiopathic interstitial pneumonia. Further study may reveal the metabolism of neutrophil elastase-inhibitors in dialysis-patients. |