In a normal situation, smothering requires at least partial obstruction of both the nasal cavities and the mouth to lead to asphyxia. Smothering with the hands or chest is used in some combat sports to distract the opponent, and create openings for transitions, as the opponent is forced to react to the smothering. In some cases, when performing certain routines, smothering is combined with simultaneous compressive asphyxia. One example is overlay, in which an adult accidentally rolls over onto an infant during co-sleeping, an accident that often goes unnoticed and is mistakenly thought to be sudden infant death syndrome. Other accidents involving a similar mechanism are cave-ins or when an individual is buried in sand or grain. In homicidal cases, the term burking is often ascribed to a killing method that involves simultaneous smothering and compression of the torso. The term "burking" comes from the method William Burke and William Hare used to kill their victims during the West Port murders. They killed the usually intoxicated victims by sitting on their chests and suffocating them by putting a hand over their nose and mouth, while using the other hand to push the victims jaw up. The corpses had no visible injuries, and were supplied to medical schools for money. Compressive asphyxia
Compressive asphyxia (also called chest compression) is mechanically limiting expansion of the lungs by compressing the torso, preventing breathing. "Traumatic asphyxia" or "crush asphyxia" usually refers to compressive asphyxia resulting from being crushed or pinned under a large weight or force, or in a crowd crush.
Zafirlukast is an orally administered leukotriene receptor antagonist (LTRA) used for the chronic treatment of asthma. While zafirlukast is generally well tolerated, headache and stomach upset often occur. Some rare side effects can occur, which can be life-threatening, such as liver failure. Churg-Strauss syndrome has been associated with zafirlukast, but the relationship isnt thought to be causative in nature. Overdoses of zafirlukast tend to be self-limiting. Zafirlukast, like other LTRAs, works by inhibiting the immune system. Through its action on inflammatory cells in the lungs, zafirlukast reduces the production of inflammatory mediators that are implicated in the pathogenesis of asthma. Zafirlukast is extensively hepatically metabolized by an enzyme called CYP2C9. Zafirlukast inhibits the action of CYP3A4, leading to drug-drug interactions with other drugs that are metabolized by CYP3A4. Genetic differences in LTC4 synthase and CYP2C9 may predict how a person reacts to zafirlukast treatment. Zafirlukast (brand name Accolate) was the first cysteinyl leukotriene receptor antagonist approved in the United States. It is now approved in many other countries under other brand names. Medical uses
Zafirlukast is FDA-approved for the prevention and treatment of asthma in adults and children older than 5 years old. Like other leukotriene receptor antagonists, zafirlukast is thought to be useful for the long-term treatment of asthma, but it is generally less effective than inhaled glucocorticoids as monotherapy (which are the standard of care) or long-acting beta-2 agonists in combination therapy. Notably, zafirlukast is ineffective in the event of an acute asthma attack.