Anti-asthmatic Drugs Research Articles

ВЛИЯНИЕ ОСОБЕННОСТЕЙ КЛИНИЧЕСКОГО ТЕЧЕНИЯ, ТЕРАПЕВТИЧЕСКОГО ПОДХОДА НА РИСК РАЗВИТИЯ И ПРОГРЕССИРОВАНИЯ СЕРДЕЧНО-СОСУДИСТОЙ ПАТОЛОГИИ У БОЛЬНЫХ БРОНХИАЛЬНОЙ АСТМОЙ

The problem of comorbidity is becoming one of the main ones in modern clinical medicine, and the combination of bronchial asthma (BA) and cardiovascular diseases (CVD) is the most common in the general structure. Asthma is currently considered as an allergic disease of the respiratory tract, in which the inflammatory process plays a leading role. CVD is an inflammatory disease where type 2 cytokines often play a protective role. Numerous clinical studies demonstrate the relationship between allergic asthma and the risk of developing CVD, including coronary heart disease (CHD), atrial fibrillation, myocardial hypertrophy, arterial hypertension (AH). Mast cells, eosinophils, inflammatory cytokines, and immunoglobulin (Ig)E accumulate in the lungs of AD patients and in the damaged heart and blood vessels of CVD patients. Many drugs for the treatment of AD have been shown to affect the risk of CVD. Thus, allergic asthma and CVD may have common pathogenetic mechanisms. There is evidence that anti-asthma drugs have therapeutic potential in some CVDs.

Stability Indicating Rp-Hplc Method Development and Validation for Simultaneous Quantification of Antihistaminic & Anti-Asthmatic Drug in Bulk and Tablet Dosage Form

The main aim of the present research work was to study Prospective process validation of Vildagliptin 50 mg uncoated tablet which is an Antidiabatic drug. Quality cannot be adequately assured by in- process and finished product testing but it should be built into the various stages of manufacturing process. The Process Validation was carried out for three consecutive batches manufacturing process, equipment, formula and validation criteria. The critical parameters involved in dry mixing, granulation, drying, Pre - lubrication, lubrication and compression stages, were identified, monitored and found in state of control. All the in process parameters and process variables were checked and found well within acceptance criteria. Loss on drying is not more than 2.5 % at 105 °C for 4 minutes by halogen moisture balance, Uniformity of Blend (By HPLC) was found within 10.0 % of the mean of the results and the % RSD not more than 5.0 %, Assay (By HPLC) for drug content is 47.5 mg to 52.5 mg was within the acceptable limit for the samples which were collected after lubrication stage (95.0 % to 105.0 %). The % LOD for dried granules after drying found out within 1.0 %w/w to 3.0 % w/w, In process testing for compression (Avg. wt. 20 Tab.: 194 mg to 206 mg; hardness 3.00-9.00 kg/cm2, thickness 2.95-3.55 mm; diameter 7.90-8.30 mm; friability NMT 1.0 % w/w; Disintegration time NMT 15 minutes and uniformity of dosage units found within acceptance value not more than 15.0 %).

Analysis of drug therapy for bronchial asthma

The review considers the main groups of drugs used to treat bronchial asthma depending on the severity of the disease. The mechanisms of action and effectiveness of taking anti-asthma drugs, their combinations and side effects are covered in detail. Particular attention is paid to targeted therapy with biological drugs, the action of which is aimed at reducing the allergic and inflammatory response in patients with severe asthma. This approach to therapy allows to change the natural course of the disease, reduce airway inflammation without side effects associated with glucocorticosteroids. The review of the current available drug therapies may be useful to clinicians in selecting appropriate strategies for the asthma treatment.

Prevalence of Spirometry Testing among Patients with Asthma and COPD in German General Practices.

The goal of this study was to estimate the prevalence of spirometry testing among patients with asthma and chronic obstructive pulmonary disease (COPD) in general practices (GPs) in Germany. This retrospective cross-sectional study was based on data from the Disease Analyzer database (IQVIA), This retrospective cross-sectional study included all patients with at least one confirmed asthma or COPD diagnosis in one of those 50 general practices in Germany between January 2020, and January 2021, as well as at least one visit to these general practices between January 2021, and January 2022. The main outcomes of the study aimed to ascertain the proportion of spirometry testing among asthma and COPD patients between January 2021, and January 2022, overall, and separately, in men, women, six age groups (≤30, 31-40, 41-50, 51-60, 61, 70, >70), and patients who received at least one prescription of anti-asthma or anti-COPD drugs. This study included 8835 patients with asthma only, 5597 with COPD only, and 1897 with both asthma and COPD diagnoses. Of these, 27.2% of COPD patients, 7% of asthma patients, and 54.7% of asthma + COPD patients, received spirometry testing during the study period. Among COPD and asthma + COPD patients, the prevalence of spirometry testing was much higher in women than in men (COPD: 31.6% vs. 23.2%; asthma + COPD: 59.6% vs. 46.3%) and much higher in treated than in non-treated patients (COPD: 31.7% vs. 15.0%; asthma + COPD: 57.5% vs. 27.8%). The prevalence of spirometry testing was relatively low among COPD and asthma patients followed in GP practices, but usually higher in female patients, treated patients, and patients suffering from both asthma and COPD.

Colon Targeting: A Novel Drug Delivery System

The oral route is considered to be the most preferred route for administration of drugs for systemic effect, but the oral route is not suitable to the administration of drug for lower gastrointestinal (GI) diseases, this happened due to their release at upper GI tract (stomach, small intestine), which further minimizes the accessibility of drugs at the lower GI tract. To overcome this difficulty, colon-specific drug delivery systems have been broadly analyzed during the last two decades. Colonic drug delivery has gained increased importance not just for the delivery of the drugs for the treatment of local diseases associated with the colon like Crohn’s disease, ulcerative colitis, etc. but also for the systemic delivery of proteins, therapeutic peptides, anti-asthmatic drugs, antihypertensive drugs, and anti-diabetic agents. This review article discusses, in brief, the introduction of the colon, factor affecting the colonic transition, colonic diseases and the novel and emerging technologies for colon targeting.

Asthma History, Current Situation, an Overview of Its Control History, Challenges, and Ongoing Management Programs: An Updated Review.

Asthma is a disease of the airways that is characterized by chronic inflammation and disordered airway function. The purpose of writing the current review paper is to review the history, current situation, control history, challenges, and ongoing management programs of asthma. Some official websites of known respiratory professional bodies were consulted for asthma guidelines, and information from Google Scholar® and PubMed® was also consulted. We reviewed around two hundred eight papers, and then, inclusion and exclusion criteria were applied to prepare this manuscript. Out of these papers, thirty papers, factsheets, and some official websites were used to prepare this manuscript. Physicians should follow already existing asthma guidelines in order to manage asthma. All prescribed medications should be continued. The government should make and adopt more strategies to promote the rational use of anti-asthmatic drugs and healthcare facilities and also make plans to disseminate more awareness among people about the schemes and programs made for safeguarding people against this life-threatening disease. We have done so much advancement to fight against this deadly disease, and we still need time to make the globe asthma-free. The number of people suffering from asthma is more than the number of people suffering from HIV infection and tuberculosis. Understanding the recommendations of professional bodies will assist in medical decision-making in asthma management. The individual needs of patients should be considered by healthcare professionals.

Ligand-Enabled Pd(II)-Catalyzed β-Methylene C(sp3)-H Arylation of Free Aliphatic Acids.

Ligand development has enabled rapid advances in Pd(II)-catalyzed β-methyl C(sp3)-H activation of free carboxylic acids. However, there are only a handful of reports of free-acid-directed β-methylene C(sp3)-H activation, all of which are limited to intramolecular reactions. Herein, we report the first Pd(II)-catalyzed intermolecular β-methylene C(sp3)-H arylation of free aliphatic acids, which is enabled by bidentate pyridine-pyridone ligands. The bite angle of this ligand has been discovered to play a key role in promoting β-methylene C-H activation of free carboxylic acid. This new transformation provides a disconnection for alkylation of arenes with simple aliphatic acids. A variety of free aliphatic acids, including the antiasthmatic drug seratrodast, were compatible with the reported protocol.

Antiasthmatic Compounds Targeting β2-Adrenergic Receptor from Perilla frutescens Improved Lung Inflammation by Inhibiting the NF-κB Signaling Pathway.

Asthma is a highly prevalent and heterogeneous chronic respiratory disease and is often treated with inhaled corticosteroids or in combination with a β2-adrenergic receptor (β2-AR) agonist. However, around 5% of asthma remains uncontrolled, and more effective antiasthmatic drugs with known mechanisms are in high demand. Herein, we immobilized β2-AR on the polystyrene amino microsphere surface in a one-step fashion. The successful immobilization of β2-AR was verified by scanning electron microscopy and chromatographic analysis. We screened rosmarinic acid (RA) as the bioactive compound targeting β2-AR in Perilla frutescens (L.) Britton by mass spectroscopy. The binding constant between RA and β2-AR was determined to be 2.95 × 104 M-1 by adsorption energy distribution and frontal analysis. The antiasthmatic effect and mechanism of RA were examined on a murine model of allergic asthma induced by ovalbumin (OVA) and aluminum hydroxide. The results showed that RA significantly reduced lung inflammatory cell numbers, the production of Th2 cytokines, and the secretion of total IgE, OVA-specific IgE, and eotaxin. The decreased inflammatory cell infiltration and mucus hypersecretion were associated with the inhibition of the NF-κB signaling pathway. Moreover, the mRNA expression levels of AMCase, CCL11, CCR3, Ym2, and E-selectin in the lung tissues were effectively reduced. It is the first time that RA was proven to target β2-AR and be effective in counteracting allergic airway inflammation via the NF-κB signaling pathway. Therefore, the immobilized β2-AR preserves the potential in screening antiasthmatic compounds from herbal medicine, and RA can be developed as an effective agent for the treatment of allergic asthma.

Does Vitamin D Work Synergistically with Anti-Asthmatic Drugs in Airway Remodeling?

Vitamin D is commonly known for its properties of airway remodeling inhibition. Due to this, we decided to analyze the action of calcitriol with anti-asthmatic drugs in airway remodeling. The HFL1 cell line was treated with calcitriol, beclomethasone 17-propionate, montelukast sodium, LTD4 and TGF-β in different combinations. Real-time PCR was used to analyzed the expression of ACTA2, CDH-1, Vimentin, ADAM33, MMP-9 and CysLTR1 on the mRNA level, whereas Western blot was used to analyze gene expression on the protein level. One-way analysis variants, the Kruskal-Wallis test, Student's t-test or Welch's t-test were used for statistical analysis. Concerning the results, pre-treatment with calcitriol increased the inhibitory effect of beclomethasone 17-propionate and montelukast sodium on the expression of ACTA2 (p = 0.0072), Vimentin (p = 0.0002) and CysLTR1 (p = 0.0204), and 1,25(OH)2D3 had an influence on the effects of beclomethasone 17-propionate and montelukast sodium and of CDH1 expression (p = 0.0076). On the protein level, pre-treatment with calcitriol with beclomethasone 17-propionate and montelukast sodium treatment decreased ACTA2 expression in comparison to the LT (LTD4 and TGF-β) control group (p = 0.0191). Hence, our study not only confirms that vitamin D may inhibit airway remodeling, but also shows that vitamin D has a synergistic effect with anti-asthmatic drugs.

Punicalagin attenuated allergic airway inflammation via regulating IL4/IL-4Rα/STAT6 and Notch- GATA3 pathways.

Allergic asthma is an inflammatory disease of the airways which has a complex etiology. Punicalagin, a major polyphenol present in pomegranates, is reported to possess various biological properties including antioxidant and antiproliferative effects. The current research aimed to evaluate the antiasthmatic effects of punicalagin in an ovalbumin (OVA)-induced experimental model of asthma in female BALB/c mice. Treatment group animals received punicalagin (12.5, 25 or 50 mg kg-1 body mass) per day for 21 days from day 1 of OVA injection. Dexamethasone (DEX) was administered to a separate group of mice, as the standard drug control. Inflammatory cell infiltration into the broncho-alveolar lavage fluid (BALF) was substantially decreased in punicalagin-treated mice. Punicalagin reduced Th2-derived cytokines and OVA-specific IgE levels. The IL-4/STAT6 and Notch/GATA3 signalling pathways were regulated on punicalagin administration. The data obtained illustrate the potency of punicalagin as an anti-asthmatic drug. Conclusively, the study's observations suggest the potential therapeutic efficiency of punicalagin in allergic asthma.

Blockade of Platelet CysLT1R Receptor with Zafirlukast Counteracts Platelet Protumoral Action and Prevents Breast Cancer Metastasis to Bone and Lung.

Metastases are the main cause of death in cancer patients, and platelets are largely known for their contribution in cancer progression. However, targeting platelets is highly challenging given their paramount function in hemostasis. Using a high-throughput screening and platelet-induced breast tumor cell survival (PITCS) assay as endpoint, we identified the widely used anti-asthmatic drugs and cysteinyl leukotriene receptor 1 (CysLT1R) antagonists, zafirlukast and montelukast, as new specific blockers of platelet protumoral action. Here, we show that human MDA-B02 breast cancer cells produce CysLT through mechanisms involving microsomal glutathione-S-transferase 1/2/3 (MGST1/2/3) and that can modulate cancer cell–platelet interactions via platelet–CysLT1R. CysLT1R blockade with zafirlukast decreased platelet aggregation and adhesion on cancer cells and inhibited PITCS, migration, and invasion in vitro. Zafirlukast significantly reduced, by 90%, MDA-B02 cell dissemination to bone in nude mice and reduced by 88% 4T1 spontaneous lung metastasis formation without affecting primary tumor growth. Combined treatment of zafirlukast plus paclitaxel totally inhibited metastasis of 4T1 cells to the lungs. Altogether, our results reveal a novel pathway mediating the crosstalk between cancer cells and platelets and indicate that platelet CysLT1R represents a novel therapeutic target to prevent metastasis without affecting hemostasis.

Short-term effects of the anti-asthmatic drug, montelukast, in female rats

Short-term effects of the anti-asthmatic drug, montelukast, in female rats

A “hydroxyl radicals standard” for evaluating the efficacy of anti-asthma drugs by using a two-photon NIR optical sensor

Asthma is a common chronic inflammatory disease of the airways and a condition closely associated with oxidative stress. However, the lack of effective biomarkers and non-invasive real-time monitoring tools remains a great challenge for the early diagnosis and therapy of asthma. Hydroxyl radicals represent a key reactive oxygen species in biological systems, and therefore the change of hydroxyl radical level may be observed to be elevated in asthmatic mice. To verify this conjecture, in this paper, we designed the first two-photon (TP) near-infrared (NIR) fluorescent probe to be used with high selectivity for monitoring the fluctuating changes of hydroxyl radicals. More importantly, using this new probe, we have successfully observed the changes of hydroxyl radicals during asthma by visualization means for the first time. Immediately following the imaging experiments on mice, we also found that the therapeutic effect of using the combination of budesonide and terbutaline administration in asthmatic mice was effective than what was achieved by the administration of budesonide or terbutaline alone. These findings suggest that this probe has the potential to be a powerful tool for future asthma diagnosis and assessment of the therapeutic effect of asthma co-administration. Notably, it is expected to establish a “hydroxyl radicals standard” for evaluating the efficacy of anti-asthma drug therapy by using fluorescence imaging techniques.

The Impact of COVID-19 on Pharmaceutical Shortages and Supply Disruptions for Non-Communicable Diseases Among Public Hospitals of South West, Oromia, Ethiopia.

BackgroundCOVID-19 is a pandemic disease that has led to inequitable supply and shortages of essential medicines worldwide due to decreased production capacity, export bans, and national stockpiling which are affecting the global pharmaceutical supply chain. Access to essential pharmaceuticals is dependent on well-functioning supply chain systems that move medicines from the manufacturer to end users at service delivery point.ObjectiveTo assess impact of Covid-19 pandemic disease on pharmaceutical shortages and supply disruptions for non-communicable diseases among public hospitals of South West, Oromia, Ethiopia.Methods and MaterialsA multi-institutional cross sectional study design was employed. Quantitative and qualitative methods were utilized concurrently to gather data from four public hospital warehouses, dispensaries, patients, and local health authorities from March 1–30, 2021 in Ilu-Ababor and Buno-Bedelle Zones, Oromia, Ethiopia. Data were analyzed by using SPSS (version 23.0). A semi-structured interview guide was used to gather qualitative information from key informants from DTC members, patients, and local health authorities and finally analyzed through thematic approach.ResultsFrom six public hospitals in the two zones; cost of medicine increased more in Dedesa hospital compared to the other public hospital found in that zone and the effect of Covid-19 on essential medicines used for treatment of non-communicable diseases was less in Darimu Hospital. Stock status of PFSA and transportation were the major challenges during the procurement process due to Covid-19 pandemic disease. Among the EMs assessed at public hospitals, drugs used for cardiovascular diseases were out of stock for more than 90 days while anti-asthma drugs were out of stock for less than 40 days.ConclusionThe availability of essential medicine was low and there was also poor inventory management practice in some of the public hospitals during Covid-19 pandemic in the study period.

Covalent immobilization of beta2 adrenergic receptor through trans-methylation reaction by SNAP-tag and its application in anti-asthmatic compound screening from Raphani Semen

Beta2-adrenergic receptor (β2-AR) is believed as an attractive target for anti-asthmatic drugs. Its crystal structure and pharmacological activity have been clearly investigated. Yet the number of the approved anti-asthmatic drugs has declined in recent years. This work reports on the preparation of an immobilized β2-AR column through the specific trans-methylation reaction between SNAP tag and the benzyl-guanine derivative and application in anti-asthmatic compound screening from Raphani Semen. The characterization of the immobilized β2-AR was performed by scanning electron microscopy (SEM) and receptor-ligand interaction analysis by chromatographic methods. SEM analysis showed that the receptor has been successfully coated on the surface of PEGA amino microspheres. Binding constants of salbutamol and terbutaline calculated from frontal analysis within the temperature range of 10–30 ℃ confirmed the feasibility of the method in a thermodynamic viewpoint. Hydrogen bond was verified as the main driving force for drug-receptor interaction analysis. Sinapine was identified as the potential bioactive compound in Raphani Semen that specifically bind with β2-AR with a specific binding site of Ser 207. Taking together, the immobilized β2-AR column is promising in exploring drug-protein interaction analysis and anti-asthmatic drug screening.

Pharmacogenomics of Leukotriene Modifiers: A Systematic Review and Meta-Analysis.

Pharmacogenetics research on leukotriene modifiers (LTMs) for asthma has been developing rapidly, although pharmacogenetic testing for LTMs is not yet used in clinical practice. We performed a systematic review and meta-analysis on the impact of pharmacogenomics on LTMs response. Studies published until May 2022 were searched using PubMed, EMBASE, and Cochrane databases. Pharmacogenomics/genetics studies of patients with asthma using LTMs with or without other anti-asthmatic drugs were included. Statistical tests of the meta-analysis were performed with Review Manager (Revman, version 5.4, The Cochrane Collaboration, Copenhagen, Denmark) and R language and environment for statistical computing (version 4.1.0 for Windows, R Core Team, Vienna, Austria) software. In total, 31 studies with 8084 participants were included in the systematic review and five studies were also used to perform the meta-analysis. Two included studies were genome-wide association studies (GWAS), which showed different results. Furthermore, none of the SNPs investigated in candidate gene studies were identified in GWAS. In candidate gene studies, the most widely studied SNPs were ALOX5 (tandem repeats of the Sp1-binding domain and rs2115819), LTC4S-444A/C (rs730012), and SLCO2B1 (rs12422149), with relatively inconsistent conclusions. LTC4S-444A/C polymorphism did not show a significant effect in our meta-analysis (AA vs. AC (or AC + CC): −0.06, 95%CI: −0.16 to 0.05, p = 0.31). AA homozygotes had smaller improvements in parameters pertaining to lung functions (−0.14, 95%CI: −0.23 to −0.05, p = 0.002) in a subgroup of patients with non-selective CysLT receptor antagonists and patients without inhaled corticosteroids (ICS) (−0.11, 95%CI: −0.14 to −0.08, p < 0.00001), but not in other subgroups. Variability exists in the pharmacogenomics of LTMs treatment response. Our meta-analysis and systematic review found that LTC4S-444A/C may influence the treatment response of patients taking non-selective CysLT receptor antagonists for asthma, and patients taking LTMs not in combination with ICS for asthma. Future studies are needed to validate the pharmacogenomic influence on LTMs response.

Effect of Agmatine on a mouse model of allergic airway inflammation: A comparative study

Introduction Asthma is a chronic lung disease that injures and constricts the airways. This study evaluates the effects of agmatine on ovalbumin (OVA)-induced allergic inflammation of the airways. Methods OVA sensitization by intraperitoneal injection was used to induce airway inflammation in mice on days 0 and 7; then the mice were challenged using beclomethasone (150 µg/kg, inhalation), a standard anti-asthmatic drug, from day 14 to day 16. Furthermore, agmatine (200 mg/kg) was intraperitoneally injected on day 0 and then daily for 16 days, followed by OVA challenge. The lung weight ratio, total and differential cell counts, TNF-α, interleukin-5 (IL-5) and IL-13 in bronchoalveolar lavage fluid (BALF), lung nitrite/nitrate (NO), and oxidative parameters were determined. Moreover, histopathological and immunohistochemical staining was employed. Results Injection of agmatine (200 mg/kg) for 16 days significantly attenuated inflammation of the airways. The levels of BALF inflammatory cells, TNF-α, IL-5, IL-13, lung NO, and malondialdehyde (MDA), significantly decreased with concomitant elevation of superoxide dismutase (SOD) levels. Histological and immunohistochemical analyses of mast cells paralleled to biochemical improvements. Conclusion Finally, this study illustrated that agmatine attenuates the allergic inflammation of airways caused by OVA by mitigating cytokines release, NO expression, and oxidative stress.

Codonopsis laceolata Water Extract Ameliorates Asthma Severity by Inducing Th2 Cells’ and Pulmonary Epithelial Cells’ Apoptosis via NF-κB/COX-2 Pathway

Asthma is an incurable pulmonary disease with several symptoms, including abnormal breathing, coughing, and sleep apnea, which can lead to death, and the population of asthma patients has been increasing worldwide. There are many adverse effects in current drugs, and thus, we have tried to develop anti-asthmatic agents from natural products such as Codonopsis laceolata. To define the anti-asthmatic effect and the mechanism of Codonopsis laceolata, an animal study was conducted considering different cell counts of BALF, serum IgE levels, morphological changes in the pulmonary system, the Th2 cell transcription factor (GATA-3), and the apoptotic pathway (NF-κB/COX-2). Codonopsis laceolata significantly suppressed the representative asthmatic changes, such as airway remodeling, mucous hypersecretion, epithelial hyperplasia, and inflammatory cell infiltration, in the respiratory system. It suppressed the levels of GATA-3, IL-4, and IL-13. The down-regulation of Th2-related factors, such as GATA-3, IL-4, and IL-13, results from the stimulated apoptosis of Th2 cells and epithelial cells via a decrease in the levels of NF-κB and COX-2. We concluded that Codonopsis laceolata might be a promising anti-asthmatic drug.

Doxofylline for Pediatric Asthma Steps 1–4. Pediatric Asthma: New Role for an Old Drug

The panoply of anti-asthma drugs for children between 6 and 18 years is not limited to those reported in the guidelines. In this review, we will re-assess the role of doxofylline, a xanthine characterized by a much higher handling than that of theophylline, as add-on treatment in pediatric asthma grade 1–4. Ten studies evaluated doxofylline in the treatment of asthma of patients non-responsive to the first-line inhaled corticosteroids. Of these, two included children and one was exclusively pediatric. According to their results, doxofylline exerts a powerful bronchodilator and anti-inflammatory activity, which can be exploited when the inhaled oral corticosteroids are not sufficient to get the desired effect of reducing symptoms. Unlike theophylline, doxofylline does not require blood testing. It can be administered together with or as an alternative to a series of other drugs considered in additional therapy.

Adverse Drug Events Related to Common Asthma Medications in US Hospitalized Children, 2000-2016.

The reduction in adverse drug events is a priority in healthcare. Medications are frequently prescribed for asthmatic children, but epidemiological trends of adverse drug events related to anti-asthmatic medications have not been described in hospitalized children. The objective of this study was to report incidence trends, risk factors, and healthcare utilization of adverse drug events related to anti-asthmatic medications by major drug classes in hospitalized children in the USA from 2000 to 2016. A population-based temporal analysis included those aged 0-20 years who were hospitalized with asthma from the 2000 to 2016 Kids Inpatient Database. Age-stratified weighted temporal trends of the inpatient incidence of adverse drug events related to anti-asthmatic medications (i.e., corticosteroids and bronchodilators) were estimated. Stepwise multivariate logistic regression models generated risk factors for adverse drug events. From 2000 to 2016, 12,640 out of 698,501 pediatric asthma discharges (1.7%) were associated with adverse drug events from anti-asthmatic medications. 0.83% were adverse drug events from corticosteroids, resulting in a 1.14-fold increase in the length of stay (days) and a 1.42-fold increase in hospitalization charges (dollars). The overall incidence (per 1000 discharges) of anti-asthmatic medication adverse drug events increased from 5.3 (95% confidence interval [CI] 4.6-6.1) in 2000 to 21.6 (95% CI 18.7-24.6) in 2016 (p-trend = 0.024). Children aged 0-4 years had the most dramatic increase in the incidence of bronchodilator adverse drug events from 0.2 (95% CI 0.1-0.4) to 19.3 (95% CI 15.2-23.4) [p-trend ≤0.001]. In general, discharges among asthmatic children with some comorbidities were associated with an approximately two to five times higher odds of adverse drug events. The incidence of adverse drug events from common anti-asthmatic medications quadrupled over the past decade, particularly among preschool-age children who used bronchodilators, resulting in substantial increased healthcare costs. Those asthmatic children with complex medical conditions may benefit the most from adverse drug event monitoring.