Asthma, Part 2 — Treatment and side-effects
Symptoms
When an individual with asthma is not having an asthma attack, there are no symptoms
of the disease. However, during an asthma attack, the person may have difficulty
breathing or may breathe very rapidly. Shortness of breath may be a symptom, even
when the person is at rest.
In order to breathe, a child with asthma may have to
use the muscles around the chest and may experience some discomfort or pain as a
result. Wheezing and a constant, “barking” kind of cough may be signs of an asthma
attack. Some kids have a cough even when they are feeling well. A persistent nighttime
cough is a common sign of asthma, and may appear without other symptoms.
Asthma may be diagnosed by a physical exam. The doctor may hear wheezing and the
effects of asthma in a patient’s lungs. An instrument called a spirometer may be
used to make the diagnosis of asthma. At home, people might use another instrument called a “peak
flow meter” which can let them know how well air is moving in and out of the lungs.
If there is a loss of peak flow, it can signal an asthma attack.
Treatment
If a child has asthma, it is important that she see an allergist, a doctor who
specializes in the care of persons with asthma. This person can work in conjunction
with the pediatrician to develop a plan that helps eliminate asthma triggers while
monitoring symptoms of the disease. Parents, pediatrician and the allergist should
also develop a plan for what is to be done if the child begins to have active signs
of an asthma attack.
There are two basic kinds of medication for the treatment of asthma, long-term control
medications and quick-acting, or "rescue", medications. The long-term control medications
are used on a regular basis and designed to prevent attacks. Quick-acting medications
are used to treat the active symptoms of an asthma attack.
For children with mild,
infrequent asthma, rescue medication may be the only type required. A good treatment
program for a child with persistent asthma will incorporate both types of medications.
A severe asthma attack will require medical evaluation, and may result in hospitalization,
oxygen, and intravenous medications.
- Long-term control medications
- Inhaled steroids (e.g. Azmacort, Vanceril, AeroBid, Flovent) to prevent inflammation
- Leukotriene inhibitors (e.g., Singulair, Accolate)
- Long-acting bronchodilators (e.g. famoterol, Serevent) to help open airways
- Cromoyn 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
- Short acting bronchodilators (e.g. Proventil, Xopenex, Ventolin, etc.)
- Oral or intravenous corticosteroids (e.g. prednisone, methylprednisolone) to stabilize
severe episodes.
Treatment of asthma in children may pose some challenges. It is often difficult
for kids to use inhalers, so their medication may be dispensed through a nebulizer.
Dosages of medications for children are different than those for adults.
Families
can help a child with asthma significantly by ridding the indoor environment of
potential triggers (e.g. dust, pet dander, etc.). Ridding the child’s environment
of tobacco smoke is one of the single most important factors in reducing asthma
attacks. Smoking outside is not enough, as the residue in clothing and hair may
cause an asthma attack in a child.
Children with asthma need the adults in their world to help them control triggers
that may cause a serious asthma attack. Some of the ways adults can help include:
- Keep low levels of humidity in the house
- Fix leaks that can result in the growth of organisms such as mold
- Eliminate cockroaches from the environment by cleaning and keeping all food in
containers and out of bedrooms
- Use only unscented cleaners and detergents
- Use "allergy proof" polyurethane-coated casings on bedding (to reduce exposure
to dust mites)
- Encourage the child to use a peak flow meter to anticipate when she may be heading
toward an asthma attack (recommended for children over the age of 5 years.
Due to the increase in the incidence of asthma, many people believe it is so common
that it is no longer a diagnosis that causes concern. That is a dangerous and erroneous
belief. With good treatment, a child with asthma can lead a normal life. However,
it is important to remember that asthma can be a life-threatening condition.
Working
together as a team – the child, parents, health-care providers and school staff
– will ensure the best possible outcome for the student with asthma.
Asthma, Part 2 — Treatment and side-effects
For more information, please contact:
Kathy Davis, MSEd, PhD
kdavis2@kumc.edu
(913) 588-6305