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Asthma In Children

Medicines To Deal With Asthma Symptoms

Friday, March 16, 2012 - 17:28

Contributing Author: Guy Slowik FRCS

The safest and most effective way of opening up the air passages in the lungs when an attack is about to start or has started is by using medications called bronchodilators. They are the "rescue medications."

These medicines are taken as soon as coughing or wheezing starts. Once the symptoms end, the child may need to continue taking the medication for a few days or a week, along with any other medications they may be taking.

Bronchodilators are best taken by inhaling them so that the medication can go directly to the lungs where it is needed. They are also available as tablets.

Nice To Know

Bronchodilate means to "open up air passages" and that is exactly what these medications do. They achieve this by relaxing the tight muscles that narrow the air passages during an asthma attack. They also help clear out the mucus that clogs the airways during an attack.

Your child should see the doctor regularly while taking medications to check growth, measure lung function and discuss and determine if the dose needs to be changed.

If side effects do occur, keep track of them, and tell the doctor. Often, side effects will go away after a few days. If not, the doctor may want to change the medication, or give the same medication in a different form.

Medications To Prevent Attacks

TRADE NAME

GENERIC NAME

REMARKS

Intal Tilade

Cromolyn Nedocromil

  • Well tolerated
  • May irritate the throat and cause child to cough when taking it. Drinking water usually helps
  • Tilade tastes bad for some children; therefore, best tried before being prescribed

Theodur Slobid Uniphyl

Theophylline

  • Used to be the main asthma medication; now replaced by newer drugs
  • Still is the most effective in preventing attacks during sleep
  • Blood tests needed from time to time to make sure dose is correct
  • Fever can affect the way it works (temperature over 100 degrees Fahrenheit)
  • Overdose may cause sleeplessness, nausea, vomiting, and rarely seizures and/or heart problems
  • May interact with other drugs especially erythromycin

Accolate Singulair

Serevent

Montelukast Zafirlukast

Salmeterol

  • Useful for preventing exercise-induced asthma
  • Used to prevent attacks in those with mild asthma
  • Well tolerated; headaches, dizziness and nausea may occur in some children

Medications For Dealing With An Attack (Bronchodilators)

TRADE NAME

GENERIC NAME

REMARKS

Ventolin Proventil

Maxair Alupent

Bricanyl, Brethine

Albuterol

Pirbuterol

Metaproterenol

Terbutaline

  • The child should breathe more easily within 5-10 minutes after taking the medication
  • Should be inhaled for best results
  • Well tolerated; few side effects; may cause a faster heart rate and tremors of the hands and fingers for a couple of minutes in some children

Atrovent

Ipratropium bromide

  • Takes longer to work but effects last longer
  • Often taken together with one of the above for severe attacks
  • Inhaled for best results
  • May cause dry mouth, increased heart rate and cough in some children
  • If gets into the eyes, the pupils may dilate temporarily (black central part of eye gets larger)

Steroids

Steroids to treat asthma are quite different from the steroids that athletes take illegally to bulk up. They are the most effectiveanti-inflammatory medications available. They are used to treat severe attacks as well as to prevent attacks.

Inhaled forms (such as Beclovent, Azmacort, Vanceril, Flovent,Pulmacort, Aerobid) may be used regularly to prevent attacks. Except in high doses, they are usually well tolerated, but the child should use a spacer to avoid sores in the mouth.

For severe attacks that don't respond to initial medications, steroids (such as Prednisone) may be taken as pills or in liquid form. It is important to take these medications for no more than several days at a time, because they can produce side effects such as vomiting, headache, dizziness or trouble sleeping.

Usually, doctors try to limit oral steroids to less than a week at a time, no more than two or three times a year.

Need To Know

With heavy use, steroids can sometimes slow a child's growth. That's one reason why it's important to try avoid things that bring on an attack, so the child can get by with small doses of steroids, if any. And if the child is taking steroids, be sure he or she takes plenty of calcium for good bone development.

Asthma In Children