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Treatment of Asthma in Children 5-12

Posted Aug 24 2008 1:49pm
ANNOUNCER: When young children with asthma begin to step out into the world, the things that trigger breathing problems often change. Very young children usually have asthma attacks set off by viral infections. For older children, triggers often shift, to allergies.

JAMES KEMP, MD: This older child now has been around animals, has been around outdoor substances such as pollen, and so their asthma attacks and their nasal allergy episodes might very well be coming from these allergens.

ANNOUNCER: Sometimes allergens can be avoided, but often, they cannot. Doctors then can usually treat asthma in a child effectively with medicine.

NANCY OSTROM, MD: Anyone who has symptoms of asthma needs treatment. It's a matter of whether they need it intermittently or something of a more preventative nature.

ANNOUNCER: First comes "reliever" medicines that provide quick help if breathing becomes difficult. Another type of medicine is also prescribed for routine use.

NANCY OSTROM, MD: A major area of treatments for asthma is controller medications. What we mean by that is medications that actually affect the process of the disease, so that the symptoms won't occur.

ANNOUNCER: Inhaled corticosteroids have proven so effective, National Institutes of Health guidelines call for their daily use when children have persistent asthma. Persistent asthma means attacks more often than twice a week or two nights per month.

NANCY OSTROM, MD: The reason the inhaled corticosteroids are pivotal to asthma therapy is that they are the only class of medication that actually can heal the inflammation that's already been occurring in the airway, like swelling, mucus production and, ultimately, potential thickening of the lining of the airways and changes in pulmonary function over time.

ANNOUNCER: For children five and above, there are seven approved, inhaled corticosteroids. They are Aerobid, Azmacort, Flovent Rotodisk and Flovent, Pulmicort Respules and Pulmicort Turbuhaler, and QVAR. Sometimes parents worry about the use of these medicines, but there's little reason to.

JAMES KEMP, MD: Well, there has always been a concern about safety of steroids, and part of that is because people misinterpret that word. There are a whole variety of steroids. Some steroids are used for body-building, like athletes tend to use. But the steroids that we use to treat asthma and inflammatory processes are entirely different.

These topical sprays don't get into the body, or if they get into the body, they are what we call metabolized or broken down very, very quickly, and eliminated, so side effects are minimized.

ANNOUNCER: Doctors say that in a small number of children, inhaled corticosteroids can temporarily slow growth. But research shows this should be of little concern.

NANCY OSTROM, MD: Although there may be a modest effect on growth rate in the first year of use of inhaled corticosteroids, ultimate adult height is generally achieved.

Overall, the vast majority of patients are on good medications that can control their disease with minimal risk of effect on growth or other side effects.

ANNOUNCER: When asthma in a child is well-controlled, studies show quality of life can improve a great deal. Quality of life can also improve for the family. Parents know, and research verifies, childhood asthma affects more than just the child.

JAMES KEMP, MD: Parents were asked to fill out these surveys as to how their child's asthma affected them and their family. And in about 40 to 50 percent of the responses, there was a significant impact on the family if the child had asthma, and interestingly enough, many parents had had to miss work one or more days a year because of their child's problem. So you see a problem not only in the individual that has it, but in the family in which this individual lives.

ANNOUNCER: As many as 10 percent of children across America have asthma.

But with many effective medicines available, doctors can help ensure that in the vast majority of cases breathing problems do not interfere with the normal course of childhood.

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