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Treatment of asthma in children
C M Murphy1, S L Coonce, P A Simon
1Department of Pharmacy Practice, University of Illinois, Chicago 60612.
Insights
Childhood asthma management involves understanding its inflammatory nature and symptoms like coughing and wheezing. Treatment selection requires careful consideration of drug efficacy, safety, and patient compliance for optimal outcomes.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
- Asthma Research
Background:
- Childhood asthma is a chronic respiratory condition characterized by airway inflammation and hyperresponsiveness.
- Despite advances, childhood asthma morbidity and mortality have paradoxically increased for unclear reasons.
- Key symptoms include coughing, dyspnea, and wheezing, with classifications ranging from intermittent to severe status asthmaticus.
Purpose of the Study:
- To review the epidemiology, etiology, pathophysiology, diagnosis, and drug therapy of asthma in children.
- To highlight recent trends in childhood asthma morbidity and mortality.
- To provide an overview of available pharmacologic treatments for pediatric asthma.
Main Methods:
- Comprehensive literature review of asthma in children.
- Analysis of current understanding of asthma pathophysiology and clinical presentation.
- Evaluation of various drug classes used in pediatric asthma treatment.
Main Results:
- Asthma pathophysiology involves inflammation and airway hyperactivity.
- Several drug classes are available, including beta-adrenergic agonists, anticholinergics, cromolyn sodium, corticosteroids, and theophylline.
- Drug selection depends on efficacy, pharmacokinetics, compliance, and toxicity in young patients.
Conclusions:
- Effective management of childhood asthma necessitates a thorough understanding of the disease and its treatments.
- Treatment strategies must be individualized based on drug properties and patient-specific factors.
- Ongoing research is needed to understand the rise in childhood asthma morbidity and mortality.
Abstract:
The epidemiology, etiology and pathophysiology, clinical presentation and diagnosis, and drug therapy of asthma in children are reviewed. Recent advances in drug therapy have, for unknown reasons, been accompanied by an increase in the morbidity and mortality associated with childhood asthma. The cause of asthma is not precisely understood, but an inflammatory process and hyperactivity of airways are common findings in the disease. Asthma in children can be classified as intermittent, chronic, or indeterminate; a severe, prolonged episode not relieved by usual treatment is called status asthmaticus. The hallmark symptoms of asthma are coughing, dyspnea, and wheezing. Beta-adrenergic agonists can be used orally for diagnostic purposes or for nocturnal asthma; i.v. or s.c. for emergency treatment; or by inhalation for relief of acute asthmatic episodes. Experience with anticholinergics in children is limited, and these agents should be used only when other options have failed. Inhalation of cromolyn sodium is very safe and is useful for the prophylactic treatment of mild to moderate asthma. Corticosteroids, which are used both for acute asthmatic episodes and for long-term treatment, can be given orally, i.v., or by inhalation. Theophylline is used for prophylactic therapy in children with chronic asthma. Selection of a drug regimen is based on knowledge of efficacy, pharmacokinetics, compliance, and toxicity. The treatment of asthma in children requires consideration of drug properties in young patients. Drugs used to treat childhood asthma include beta agonists, anticholinergics, cromolyn sodium, corticosteroids, and theophylline.