Asthma Treatment for Children

December 2, 2012

What makes children asthma better? While asthma is never “cured,” a variety of FDA-approved medications can help manage symptoms.

  • For quick relief of severe symptoms, doctors will prescribe “rescue” medications, such as albuterol, which open up the bronchial tubes in the lungs. “The goal is not to use it, but have it available—at home, school, camp—just in case,” says Anthony Durmowicz, M.D., a medical officer in the FDA’s Center for Drug Evaluation and Research.
  • To stabilize chronic and persistent symptoms, doctors will prescribe “controller” medications. The most common, safe and effective controller medications are the inhaled corticosteroids (ICS). With regular treatment, they improve lung function and prevent symptoms and flare-ups, reducing the need for rescue medications, according to NHLBI.
  • Children whose asthma is triggered by airborne allergens (allergy-causing substances), or who cannot or will not use ICSs, might take a type of drug called a leukotriene modifier. These come in tablet and chewable forms, though for many people they tend to be less effective than ICSs, especially for more severe asthma, Ortiz says.
  • For more severe cases that are not controlled with ICSs or leukotriene modifiers alone, adding long-acting beta agonists (LABAs) such as salmeterol or formoterol might be recommended. FDA cautions against using LABAs alone without an ICS, and recommends that if one must be used, it should be for the shortest time possible.

Most asthma medications are inhaled. Babies and toddlers use a nebulizer, a machine that delivers liquid medication as a fine mist through a tube attached to a face mask. Older children can use a metered dose inhaler or dry-powder inhaler.

To ensure that the proper dose of medication gets into a child’s lungs, doctors might also prescribe a device called a spacer, or holding chamber which attaches to the inhaler. “There are practical advantages to using (spacers) in younger kids—the timing and coordination needed to use an inhaler is hard for them,” Durmowicz says. Once the child can use the inhaler comfortably, it’s no longer as critical, he adds. Clinical trials have shown that “the relative dose delivered to the lungs with and without the spacer is the same.”

Health care providers also might recommend the use of a peak-flow meter to check how well a child’s asthma is controlled by treatment over time. Peak flow meters measure the amount of air the child expels from the lungs.

The type and combination of medications and devices a doctor prescribes depends on severity, frequency of symptom flare-ups, the child’s age, activity schedule and sometimes cost.

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