The Centers for Disease Control and Prevention (CDC) report that nearly seven million children have asthma in the United States. Asthma symptoms include shortness of breath, wheezing, and tightness in the chest . Treatment is aimed at controlling symptoms. Most childhood asthma begins before the age of five. It can be difficult diagnose asthma; lung function tests may be impossible to administer to children. Doctors may prescribe medication to see if symptoms improve.
Rescue Inhalers
The self-administration of a bronchodilator spray provides autonomy for school-aged children who may need to use it when symptoms flare up. Rescue inhalers typically contain salbutamol, which relieves tightness in the chest within seconds. A two-puff dose should be taken one minute apart for best results. When rescue inhaler use exceeds twice a week, the National Institutes of Health recommends the addition of a low dose corticosteroid inhaler.
Corticosteroid Inhalers
Asthma is an inflammatory disease. Inhaled corticosteroids prevent inflammation, effectively controlling symptoms. Children should rinse the mouth with water after each use of drugs such as budesonide (Pulmicort) and mometasone (Asmanex) with a metered dose inhaler. This precaution, or use of a spacer device, can prevent side effects such as sore throat or oral yeast infections. Children will sleep better and have better results on lung function tests once symptoms are controlled. However, the National Institutes of Health recommends that doctors double the dose of these medications if asthma symptoms persist, or add other drugs to the asthma regimen.
Nebulizer Treatments
A nebulizer blows air through liquid medications, producing mist that children can inhale while breathing normally. This system has the added benefit of moist air to help liquefy secretions. A mix of bronchodilators and corticosteroids with saline solution can be placed in the nebulizer bowl. A treatment lasts approximately 15 minutes until the liquid is gone.
LABAs
Long-acting beta antagonist (LABA) medications, such as Serevent and Foradil, have been the subject of FDA warnings. These medications are associated with worse symptoms and death in some asthma patients. They work by relaxing smooth muscle in the lungs. The FDA cautions that LABAs should only be used with other asthma medications and be limited to short-term use. For pediatric and adolescent patients who need LABAs, the FDA recommends Advair or Symbicort, which also contain inhaled corticosteroids.
LTRAs
Leukotriene receptor antagonist (LTRA) medications such as montelukast (Singulair) and zafirlukast (Accolate) are generally safe and well tolerated by most children. They come in pill form. LTRAs inhibit the action of leukotrienes, molecules that are partly responsible for constriction, inflammation, and mucus secretion in the lungs. The most common side effect is an upset stomach. Rarely, LTRAs may cause psychiatric changes in children and adolescents, including irritability, sleep disturbances, depression, and suicidal thoughts.
