Asthma therapy Stepwise summary

4th Pediatric Infectious Diseases Conference

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Asthma in Children

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Asthma Introduction

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ASTHMA IN CHILDREN

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

Stepwise Asthma Therapy Summary

Step 1:

First intervention should be a β 2 agonist delivered promptly by an age-appropriate inhalation device. This is given repeatedly when needed. It is also the treatment of choice for prophylaxis of exercise-induced asthma.

An oral β 2 agonist syrup may be appropriate for infants and toddlers with trivial symptoms who have never required emergency care, in order to avoid the expense and bother of a nebulizer.

If sub responsiveness to beta-2 agonists is present, then high dose oral corticosteroids should be given and continued until the patient is symptom-free for 24 hours. This usually requires 5 to 10 days of therapy.

Step 2:

If poor response or needs daily use of short acting bronchodilators, one of these drugs given twice a day, can be started to prevent asthma exacerbations, depending on preference for inhaled or oral medication.

Inhaled low dose corticosteroids.

Slow-release theophylline

Inhaled cromolyn or Nedocromil sodium.

Consider Leukotriene antagonists for older patients.

Most prefer low dose inhaled steroids. Cromolyn administered by nebulizer solution may be an alternative for young children who cannot use a metered dose inhaler, even with an assist device. However, this modality is more costly and time consuming, requiring multiple daily treatments.

Next : Asthma Investigations(Contd.)

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ASTHMA IN CHILDREN : EXPERTISE VIEWS

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Use of Spirometer in Pediatric Patients other than using for diagnosis?

About bronchial asthma related to MGSO4(Mag sulphate)?

About no cold freon effect of spacers used in asthma?

Role of FeNo2 in management of Asthma?

ASTHMA IN CHILDREN : QUESTIONS AND ANSWERS

Is it safe to use inhaled steroids in a child who, as an asthmatic warrants its use?

About to give Montleukast 4 mg Preventer (Sodium Tablet)?

About Asthma relation with cough with wheezing and sickness?

About Asthma and Smoking

About inhaling Budesonide

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