Prophylaxis in childhood asthma

Opinions on the pathogenesis of bronchial asthma have changed considerably in recent years. An immunologic mechanism to explain the state of bronchial hyperresponsiveness in asthmatic patients was not widely accepted in the past. However, with increasing knowledge of immunologic, biochemical and neurogenic mechanisms, a better understanding of the pathophysiology of asthma has evolved. This has encouraged investigators to develop new drugs to control asthmatic symptoms. The treatment of asthma consists of measures to control acute attacks and to prevent recurrences. We try to present in this paper a comprehensive review of asthma prophylaxis in children. This includes environmental control, parent/patient education, physiotherapy/psychotherapy, allergy extract immunotherapy and drug prophylaxis. The pharmacologic actions, advantages and disadvantages of drugs used for prophylaxis are discussed. A double-blind investigation on the safety and efficacy of Ketotifen among Filipino asthmatic patients demonstrated beneficial results compared with other countries. An algorithm of the use of various drugs in the prophylaxis of childhood asthma is presented.