Pediatric Asthma
 My four-year-old has been diagnosed as asthmatic by the pediatrician. What can we expect?
 Asthma is extremely common but, fortunately, many children grow out of their asthma in adolescence. Asthma is an inflammatory condition of the lungs and airways, most marked by bronchospasm.
Asthmatics are especially sensitive to factors like dust, mold, animal dander from pets, cold, exercise, and sometimes aspirin. The airways become thickened and swollen (the inflammation) and constrict (the spasm). This narrowing is most marked in expiration, so the wheeze is usually in breathing out, which the child feels as tightness in the chest.
It is important to be sure there are no other conditions presenting themselves as asthma. Usually a child shows asthmatic symptoms when experiencing an upper respiratory infection.
A family doctor often treats mild asthma, but more severe forms are probably better treated by physicians specializing in respiratory problems.
The most common treatment is with a bronchodilator, which may be used before exercise or when symptomatic. The inhaler is the most common route of administration, though tablets, capsules and injections may be required. The medicine used is an agent that stimulates B2 receptors and relaxes the smooth muscles of the bronchi.
Some anti-inflammatory agents may be required if the bronchodilators are inefficient. Again, inhalation of a corticosteroid-like medication is usually effective. A recent study showed a 50 percent reduction in hospitalizations in people using prophylactic steroids.
For children, a new group of medicines called "mast-cell stabilizers" and "leukotriene modifiers" show promise.
Removing triggers from the environment can be very important: a dust-free environment, a pet-free house, damp dusting, hardwood floors, synthetic pillows and bedding. You should work out an asthma attack plan with your doctor. Understand what the medications you have been given are for and how they work. Be regular in giving the medication. Keep a list of everything you are using to show a doctor who may be unfamiliar with your problems.
Hopefully, with the growth of the airway, your little one will find that he or she is less significantly constricted and that the asthma becomes a problem of the past. Until then, follow your doctor’s advice carefully. |
