The textbook "Current Diagnosis and Treatment: Pediatrics," reports that asthma is the most common chronic disease in childhood; more than 6 million children are affected. It is a disease characterized by episodes of bronchospasm in which the muscles of the airways contract, resulting in symptoms such as wheezing, coughing, tightness in the chest and difficulty breathing. Depending on the severity, patients may require medication only during an acute asthma episode or on a daily basis to prevent symptoms from occurring. Toddlers with the disease may be treated with several types of medications.
Albuterol
Albuterol is an example of what is known as a "rescue" medication, because it is used to relieve symptoms of an asthma episode as they are occurring. Albuterol is a short-acting bronchodilator--that is, its duration of action is just a few hours--and it acts by dilating the bronchi, the airways that bring air into the lungs.
Young children between the ages of 1- and 3-years-old are given different doses of albuterol based on the type they are using. For example, the dose of inhaled albuterol, according to the medical reference UpToDate, is one to two puffs, every four to six hours, as needed. MayoClinic.com points out that children younger than 4 will need a face mask attached to the inhaler so that they can breathe normally and still get the medicine into their lungs.
UpToDate reports that using this type of medication helps to quickly improve the distressing and potentially dangerous symptoms associated with an acute asthma attack--namely, coughing, chest tightness and difficulty breathing.
Inhaled Corticosteroids
Another category of medications used in the treatment of asthma in toddlers and young children with asthma is the group known as inhaled corticosteroids. UpToDate says that they are the most powerful anti-inflammatory medicines available to treat asthma. They work by decreasing the inflammatory response and reducing the over-responsiveness in the airways of children with asthma. Unlike the short-acting bronchodilator albuterol, inhaled corticosteroids are meant to be taken on a daily basis to prevent the symptoms of asthma from occurring. Examples of inhaled corticosteroids include fluticasone and budesonide. It is important to note that only budesonide has been approved by the U.S. Food and Drug Administration in the treatment of children younger than 4.
Toddlers receive this medication via a process called nebulization, in which budesonide is turned into a very fine mist that is sprayed into the air; the young patient then breathes it in via a face mask so that the medication can reach the lungs. The recommended dose of budesonide suggested by the manufacturer depends on whether the child has been treated with other asthma medications: for instance, if he has only been on bronchodilators such as albuterol, the suggested dose is initially 0.25 mg twice daily, or 0.5 mg given once daily.
Leukotriene Receptor Antagonists
An example of a medication that would be considered a leukotriene receptor antagonist is montelukast. This type of medication works by blocking the ability of a compound called leukotriene to function properly. Leukotrienes are substances that are involved in the inflammatory response, so by blocking these substances, symptoms of asthma may be prevented. The recommended dose of montelukast for toddlers, as indicated in UpToDate, is 4 mg per day. This medication is meant to be a supplement to inhaled corticosteroid therapy and is part of maintenance therapy regimen for children with asthma.
References
- MayoClinic.com: Asthma in Children Under 5
- "Current Diagnosis and Treatment: Pediatrics;" W. Hay et. al.; 2007
- "UpToDate;" Chronic Asthma in Children Younger Than 12 Years: Controller Medications; Gregory Sawicki and Mark Dovey; June 2010
- "UpToDate;" Pediatric Drug Information: Montelukast; Lexi-Comp Inc.; August 2009
- "UpToDate;" Pediatric Drug Information: Budesonide; Lexi-Comp Inc.; 2010
