Term basis symptoms and conditions

One of the most important questions we should be asking as parents is:

How does Singulair - a leukotriene receptor antagonist (blocks the receptors) affect the normal function of the mast cell?

The mast cell is the FRONT LINE DEFENSE against invading micro-organisms. When Singulair was invented, there was limited knowledge regarding the mechanisms by which the mast cell performed it's function. In my opinion, the focus was very narrow - those interested zeroed in on how the leukotriene receptor performed a role in the cause of asthma attacks and how ashma attacks could be prevented. Well, that's good preventing asthma attacks. But what happens to the mast cell if that receptor is blocked on a long term basis. I am not suggesting that blocking the receptor is bad but what if the long term effect is different than what we are are lead to believe-which is this is a safe medication with no known long term effects. What if the leukotriene receptor was just blocked short term a week or two to allow the body to clean up the mess from the last attack?

I seriously question what is going on with all of these infections. Are they related to crippling the mast cell? Parents should be allowed to question. If Merck doesn't want to answer questions regarding what happens to the mast cell (including are the numbers of mast cell decreased on Singulair), then something really BIG is missing. If by any chance (unknown at the moment) that the mast cell is significantly changed and therapy by montelukast is proper on a short but not long term basis, so freakin' what if Singulair is not a huge money maker any more.

Parents deserve every answer possible when decisions regarding their child's growth and development is on the line. I hope that we get some answers.

Of course, what was there in 2002 were new questions-not necessarily answers about the mast cell. Did anybody apply this to Singulair studies?
May 2002

From Journal of Clinical Investigation

Pattern recognition receptors on mast cells
The Toll-like receptors (TLRs) fit the definition of pattern-recognition molecules, which were originally postulated to allow the innate immune system to detect the 'molecular signatures' of various infectious agents. Although the innate immune system has no memory, it shows a degree of specificity, in part because the various TLRs recognize different sets of pathogen-associated molecules. Dermal mast cells are usually associated, not with the innate immune system, but with atopic dermatitis, but Supajatura et al. have found that these cells also express TLRs. They report here that TLR4, which binds the gram-negative product lipopolysaccharide (LPS), and TLR2, which binds peptidoglycan (PGN) from gram-positive organisms like Staphylococcus aureus, induce distinct mast cell responses. Staphylococcus is known to exacerbate allergic dermatitis, but it has generally been thought to act by inducing antibacterial IgE's, which trigger mast cell degranulation by stimulating the IgE receptor. Interestingly, the authors show that the interaction between PGN and TLR2 can provoke mast cell degranulation directly, sidestepping the need for IgE receptor engagement.

Predisone is the only other alternative for antibiotic therapy. Predisone has been known for years to have a lot of side effects. Always keep in mind you must be weined from the medicine never stop without consulting your doctor and if your doctor gives you a dose that does not require weining please also consult your pharmacist and the pharmacist really knows the drug compared to your doctor. Doctor's typically only know what the medication reps tell them whereas the pharmacist has extensive medication knowledge and will also know your current medication conflicts. Be sure that your doctor is aware of all medications including all herbal supplements and other the counter medications. With predisone you really have to out weigh the symptoms verses the side effects then determine are they really worth going through to eleviate your symptons. Keep in mind Predisone is a steroid a very potent anti-flammitory and reduces the inflammation so the infection can heal.

I have been reading all the comments and I can't help wondering if I am atypical, but I have not had any of these side effects. In fact the only thing that Lisinopril has done for me is to lower my bp. I was 130 over 90 and now 116 over 78, so it sure works for me!

My doctor prescribed me Prednisone on May 3. I'm on 10 mg. I start out on 3 tabs 2x a day for 4 days, then 2 tabs 2x a day for 3 days, then 1 tab 1x a day for 2 days. I was put on this for a sudden attack of joint pain/stiffness/swelling of my elbows, wrists, hands, knees, ankles and feet. I was in extreme pain. So far this drug has given me no side effects other than needing to urinate a little more often than usual. My pain is gone, as is the swelling. I'm almost scared to go off this b/c of the fear of the pain coming back. My blood tests came back on Friday and my doctor told me that I had Rheumitic (sorry, I know that's spelled wrong) inflammation and if the pain did come back after I stopped the Prednisone that I'd have to do more blood tests. I just turned 30 and I'm scared to death what else might be wrong with me.

I have intense headaches after taking my lovenog injection, followed by extreme fatigue. I have never felt headaches like this before-nothing helps them.
Patty

Hi Everyone:
Thanks for all of your entries. I am comforted knowing that I am not alone in my side effects. I have been taking 20 mg of Prednisone for a very severe poison ivy inflammation. I put off taking it for two weeks, trying every other remedy I could find, but to no avail. The first few days of taking it I noticed immediately relief from the itching, BUT I also was not sleeping and I felt a euphoria. I was invincible. Then, I crashed. I have been hostile, weepy, anxious, unable to sleep more than four hours, and almost unbearable to live with. I cannot believe how powerful this drug is.

I have four days left, I will cut the dose down and start weaning off it since it makes sense to cut down slowly. Wow, I feel so badly for people who have to take this on a long term basis. Do you have any alternatives that you know of? I help people with chronic pain and would love to know what else works.

Thanks everyone!

I have been taking Paxil CR 25 mg. now for about 3 months. I don't really see any change and still have the anxiety, night sweats, no sex drive, dizziness, headaches, insomnia and a lot of other things. I am not sure what to do at this point. I was on Prozac before and felt kind of the same, maybe not as anxious. Zoloft did not work for me at all. I know for sure, you have to wean off of these drugs you cannot just stop taking it or the side effects get worse. I am going to talk to my doctor about something else. I know they do not like to give out Xanax unless it is on a short term basis.