Montelukast

So if you are going there, it's not in my stack that I usually will use, but I've got the occasional patients, it's made the world of difference.

So, Monte Lucas 10 milligrams for adults and it's $18 to try.

So, it's not an expensive thing for discount chemist.

Some people can use off-license.

For example, before I started the company and many of our patients, they have whole medicine cabinets.

full of Flonase or Singulair or Zyrtec or whatever antihistamine.

I was this my way.

Like I used to go to a bulk store and just get a whole season's worth of Flonase.

It has been shown to be highly effective in managing severe childhood sleep-wake syndromes.

The text also mentions drugs like Singulair and Flonase, which is interesting to me because those are allergy and asthma medications.

Yes, and that speaks directly to targeted diagnosis.

Those are used specifically for mild sleep-wake issues related to physical breathing difficulties.

So let's talk about some medications that are prominent with asthma and the overlap that some of them have with migraines.

So first we have Singulair.

Okay, this is a asthma sort of preventative medication.

It's a pill and a lot of kids take it for, a lot of children and adults take it for asthma and allergies.

Since 2020, Singulair has carried what's called a boxed warning or or some people will call it a black box warning.

That is the strongest warning the FDA puts on a drug.

It's for mental and emotional side effects, including in children, nightmares, agitation, depression, suicidal thoughts, and actions.

I didn't have any allergies.

And yeah, so, um, finally realized that it's asthma.

So now I've got an inhaler in the morning and inhaler at night and Silas telling me to get on some Monte Lucas if I can.

So I just gave that a Google.

So, uh, yeah, we'll figure it out.

NBA player.

So that,

uh monte lucas yeah i think he's from serbia as well so a lot of guys coming over from from serbia these days so um yeah my my problems in life are not that big i'll be all right the puppy will heal we're good to go my my biggest problem is um is the loss to houston and the loss of most phillips for the rest of the season so evan jackson's gonna need to step it up i'm sure we're gonna get to all that and much more but yeah that was a big bummer news item that dropped i believe on wednesday

Yeah, and it's interesting.

The data clearly shows that for those absolute worst case scenarios, the grade four total obstructions where the child is truly struggling to breathe, using a steroid nasal spray alone sometimes isn't enough to rapidly shrink the tissue.

The trials show that combining the nasal spray with an oral medication called Montelukast is vastly superior to monotherapy.

This raises an important question, and it really highlights one of the most agonizing clinical dilemmas in modern pediatric medicine.

We need to understand what Montelukast is.

It is a leukotriene receptor antagonist.

Okay, let's break that down.

They are synthesized from the cell membrane after the inflammatory cascade begins.

They are highly potent inflammatory mediators that cause intense, prolonged, smooth muscle constriction and massive tissue swelling.

There's a little bit of crossover there.

And my third intervention for these people with the brain fog, that rashes that they're getting, even the fatigue is to add on Montelukast, which is singular.

There's a lot of controversy about that drug.

It carries a boxed warning with regard to neuropsychiatric symptoms, but it works on leukotrienes, which is another pathway on that cascade, that allergic cascade.

Like, you take Zyrtec on the daily?

No, I take a, a medication called Montelukast, uh, which I think is a generic of-

... um, something else.

I tried to Google it, and now I can't find it.

Um, I think it starts with an S or something.

Uh, that's what I take daily is Montelukast, and it is for, uh, you know, allergies.

Man, if my son has to take allergy medicine, I'd be like, "You're such a fucking dork ass."