Treatment for asthma

Once your child has been diagnosed with asthma, your child's physician will prescribe medications to control his or her symptoms. This plan may change over time as your child grows and changes. But every child with asthma needs a plan of action, and your child's asthma action plan should be available to all his or her caregivers (at home, school, day care, grandparents, etc.).

Asthma medications

There are medications that can be used to prevent symptoms (controllers) and medications to treat symptoms when they occur (relievers).

Controllers

Controller medications decrease the swelling and inflammation in the airways. These medications also reduce mucus build-up in the airways. Controller medications can be given by inhaling them from a nebulizer, a metered dose inhaler,  or a dry powder inhaler.  The age of the patient and proper administration of the medication are the primary factors in deciding which medication to prescribe.

  • Inhaled corticosteroids are the first choice as they are the most effective of controller medications. There are many different types of steroid preparations and the use of low doses has made them much safer.  The most common side effects of inhaled corticosteroids are yeast infections in the mouth or causing a hoarse voice. To prevent these symptoms, after taking the medication have your child rinse the mouth out and if they require a mask for administration, wash the face.

Parents are often fearful that corticosteroids may cause problems with growth.  However, with appropriate delivery of these medications, particularly at low to medium doses, this should not be a concern.  If your child is requiring high doses of inhaled steroids or steroids taken by mouth on a regular basis, we recommend that your child should be monitored regularly for adverse reactions.  It is important to remember that children with chronic respiratory diseases, if untreated, also suffer from poor growth.

  • Leukotriene inhibitors are another class of controller medications. They are taken by mouth and have few side effects.  In March 2008, the FDA announced an investigation into a possible link between Singulair and behavior/mood changes, suicidal thoughts or suicide.  Based on the information currently available, patients taking Singulair should continue to take the medication as prescribed provided: 1) the patient and physician feel the medication is effective; and 2) the patient does not experience any suicidal behavior or thoughts.  Please consult the prescribing physician for your specific conerns.
  • Anti-IgE therapy binds allergic antibodies, decreasing allergic causes of inflammation in the lungs. This therapy requires injections given every 2-4 weeks in a specialist’s office and is a treatment option for those with more severe asthma.

Reliever medications

  • Bronchodilators are reliever medications that open up narrow airways by relaxing the muscles that constrict them. Bronchodilators relieve coughing, wheezing, breathlessness, and the feeling of tightness in the chest. Albuterol is one of the most commonly prescribed bronchodilators. Other names for albuterol include Ventolin HFA, Proair HFA, and Proventil HFA.  Xopenex and Maxair are other medications very similar to albuterol.

These medications work best when taken in the inhaled form, either by nebulizer or metered dose inhaler. They may cause mild restlessness in some children. They work very quickly and should be effective for 4-6 hours. If your child needs a bronchodilator more often than every 4 hours or does not experience relief from the medication, it is important that you seek medical attention.

Working together is crucial

Childhood asthma is a manageable disease. Ask questions and learn all you can about asthma and how it affects your child. Working together with your child's asthma care providers and having a home management plan will help your child stay healthy and enjoy life.