Families and their pediatrician or allergist should work together as a team to develop and carry out a plan that includes eliminating asthma triggers, monitoring symptoms, and a plan for what to do when a child's asthma starts to act up.
There are two basic kinds of medication for the treatment of asthma:
- Long-term control medications -- used on a regular basis to prevent attacks, not for treatment during an attack.
- inhaled steroids (e.g., Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
- leukotriene inhibitors (e.g., Singulair, Accolate)
- long-acting bronchodilators (e.g., famoterol, Serevent) help open airways
- cromolyn sodium (Intal) or nedocromil sodium
- aminophylline or theophylline (not used as frequently as in the past)
- combination of anti-inflammatory and bronchodilator
- Quick relief (rescue) medications -- used to relieve symptoms during an attack.
- short-acting bronchodilators (e.g., Proventil, Ventolin, Xopenex, and others)
- oral or intravenous corticosteroids (e.g., prednisone, methylprednisolone) stabilize severe episodes
Children with mild asthma (infrequent attacks) may use relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms from occuring. A severe asthma attack requires a medical evaluation and may require hospitalization, oxygen, and intravenous medications.
Although these are the same medications used to treat adults, there are different inhalers and dosages especially for children. In fact, children often use a nebulizer to take their medicine rather than an inhaler, because it can be difficult for them to use an inhaler properly.
Families play a very important role in the control of asthma by helping get rid of the indoor triggers that worsen asthma. For example, it is extremely important to eliminate tobacco smoke from the home. This is the single most important thing that a family can do to help a child with asthma. Just having people smoke "not in the house" is not enough, as family members and visitors can bring residual smoke in on their clothes and in their hair.
Keeping low levels of humidity and fixing leaks can reduce growth of organisms such as molds. Exposure to cockroaches can be reduced by cleaning and by keeping food in containers and out of bedrooms. Bedding can be covered with "allergy proof" polyurethane-coated casings to reduce exposure to dust mites. Detergents and cleaning agents in the home should be unscented.
All of these efforts can make a significant difference to the child with asthma, even though it may not be obvious right away. Your allergist can assist you with a plan for reducing the asthma triggers in your home.
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