Asthma Related Other Drugs - Control of Precipitating Factors

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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Asthma in Children

Allergic Disorders

Asthma

Anaphylaxis

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ASTHMA IN CHILDREN

Dr C.T.Deshmukh
Professor of Pediatrics, K.E.M Hospital

Other Drugs Related to Asthma

Continued...

Control of precipitating factors

There is a strong link between inhaled allergens and asthma. Exposure to irritants or allergens, which the patient is sensitive to, increases the symptoms and precipitates asthma exacerbations.

It is very important to take a careful history to identify such factors. History is usually adequate for seasonal allergies.

If available, skin testing and in vitro testing for specific IgE antibodies may be useful to identify perennial indoor allergens.

Once asthma triggers have been identified the next step is to reduce the exposure to those triggers. Avoidance of triggers requires a high level of commitment on part of the patient and family.

Avoidance is most important in moderate to severe asthmatics and may help in reducing the dosage or need for medication. Aspects of responsibility for treatment may apply to all environments in which the child spends a significant amount of time, such as preschool, school, or day care. The greatest effort is spent in relation to the bedroom, where children spend a major part of their time.

Recommendations (where ever possible):

Annual influenza vaccine for patients with persistent asthma.

Skin testing / in vitro testing for at least in persistent asthma.

Not to use chemicals to kill house dust mites / cockroaches.

Aspirin not to be used in persons sensitive to it.

Avoid exposure to all tobacco smoke limiting exposure to allergens they are sensitive to, other irritants, as well as to house dust mite, cockroach, mold, animal, and pollen allergens.

Avoid exertion when air pollution levels are high.

Exercise-induced bronchospasm is common in children. Pretreatment with B2-agonists and/or Cromolyn sodium can prevent symptoms. Optimal control of chronic asthma by anti-inflammatory therapy also can decrease the frequency and intensity of exercise induced asthma.

Avoid taking nonselective b -adrenergic antagonists (blockers for migraine, stage fright)

Consider allergen immunotherapy when connection between symptom and exposure to unavoidable allergen is clear and symptoms occur during most of the year.

The use of acyclovir and/or varicella immune globulin should be considered in children who have a negative varicella history and/or antibody titer and who receive or recently have received systemic steroids and have been exposed to varicella.

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