Asthma is a chronic medical condition in which the lung's tubes, or airways, become inflamed. Asthma attacks are triggered by several factors, including colds, allergies, changes in the weather and dust. Children in particular are prone to repeated asthma attacks, which can lead to multiple physician visits and hospitalizations. The treatments for asthma in children focus on prevention and in treating the acute attack.
Bronchodilators
During an asthma attack, the airways become narrowed with the surrounding inflammation. Bronchodilators are medicines that act on the smooth muscle surrounding the airways to relax them and "open up" the airway. The most commonly used bronchodilator is albuterol. This medicine is administered as an inhaled mist that acts promptly on the lungs, so it is used as a rescue medication, to improve the symptoms of cough and shortness of breath typical of an asthma attack. It can be used continuously, if under physician supervision, but children should only use it at home every three to four hours if needed for symptoms relief. Another common bronchodilator is ipratropium bromide. It also helps relax the smooth muscles surrounding the airways, trying to dilate them. It works in a different way than albuterol, and it is only beneficial during the first 24 hours of an asthma attack.
Steroids
Chronic inflammation causes the symptoms of asthma, so anti-inflammatory medicines like steroids work to reduce the possibility of symptoms. Health providers use steroids both during an acute attack and chronically to prevent symptoms. During an acute asthma attack, children receive steroids either intravenously or by mouth. For prevention, children use inhaled steroids on a daily basis. The doses of steroids during an acute attack are significantly larger than the doses used for prevention and, if administered frequently, can cause side effects like bone frailty and weakened immune system. The inhaled steroids used for prevention do not have these issues.
Allergy Medicines
An important trigger of asthma attacks in children is seasonal allergies. Pollen and other allergens lead to the release of substances in the bloodstream that can trigger an asthma attack. So treatment of allergies is an important component of asthma therapy to prevent attacks. Allergy medicines include antihistamines like diphenhydramine (Benadryl) and mast-cell stabilizers like Claritin. Antihistamines work to prevent the actions of histamine, a molecule that induces cells to release substances that trigger the body's allergic reaction, while mast-cell stabilizers work directly on the cells to prevent the release of histamine into the bloodstream.
