Removing cerebrospinal fluid at regular 3- to 7-day intervals is the only proven method of significantly reducing intracranial pressure and can be used for symptomatic treatment of headaches. This process may be repeated until improvement is shown. There is growing evidence of moderate quality that suggests corticosteroid therapy using prednisolone or dexamethasone has beneficial effect in treating the CNS symptoms related to A. cantonensis infections. Although early research did not show treatment with antihelminthic agents (parasite-killing drugs) such as thiobendazole or albendazole effective in improving the clinical course of the illness, a number of recent studies from Thailand and China show that the combination of glucocorticoids and antihelminthics is safe and decreases the duration of headaches and the number of patients who had significant headache. Although the addition of antihelminthic agents for management of A. cantonensis infection has a theoretic risk of precipitating a neurologic crisis by releasing an overwhelming load of antigens through simultaneous death of the larvae, no study has shown this to exist in the clinical setting. Additionally, the failure to kill parasites before they attempt to migrate out of the CNS increases the risk of mechanical damage by migrating larvae. Although combination therapy using albendazole and prednisolone has no significant advantage compared to treatment using prednisolone alone in mild cases, the treatment with antihelminthics is demonstrably safe and may have significant benefit for patients with high parasite loads at risk for permanent disability or death.
Ipratropium bromide/salbutamol, is sold under the brand name DuoNeb as a nebulized solution, is a combination medication used to treat chronic obstructive pulmonary disease (COPD). It contains ipratropium (an anticholinergic) and salbutamol (albuterol, a β2-adrenergic agonist).Common side effects include sore throat, muscle cramps, and nausea. Other side effects may include bronchospasm, allergic reactions, and upper respiratory tract infections. Safety in pregnancy is unclear. Each medication typically decreases bronchospasm and does so via different mechanisms.The combination was approved for medical use in the United States in 1996. It is available as a generic medication. In 2019, it was the 151st most commonly prescribed medication in the United States, with more than 4 million prescriptions. Society and culture
Since Combivent contains a chlorofluorocarbon-based propellant, its use was discontinued in 2013 in the United States and other countries. This was because Chloroflourocarbons (CFC) are attributed to depletion of the ozone layer. References
External links
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Consumer Medication Information from PubMed Archived 2012-12-03 at the Wayback Machine
Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Heart, Lung, and Blood Institute. 2007.