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Nonsteroidal anti-inflammatory drug administration in children with history of wheeze
Insights
Nonsteroidal anti-inflammatory drugs (NSAIDs) can be safely given to children with asthma, even those who wheeze, unless they have a history of NSAID-exacerbated respiratory disease (NERD). NSAIDs are effective pain relievers for children.
Area of Science:
- Pediatric Pharmacology
- Allergy and Immunology
Background:
- Asthma is a common condition in children.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used for pain and fever.
- Concerns exist regarding NSAID use in children with asthma due to potential respiratory reactions.
Purpose of the Study:
- To determine if asthma is a contraindication for NSAID use in children.
- To investigate the existence and prevalence of NSAID-exacerbated respiratory disease (NERD) in pediatric populations.
Main Methods:
- Literature review on NSAID use in pediatric asthma.
- Analysis of case reports and studies on NSAID-exacerbated respiratory disease (NERD).
Main Results:
- NSAIDs are effective analgesics and antipyretics.
- NSAID-exacerbated respiratory disease (NERD) is well-documented in adults but not clearly described in a large number of children.
- No clear contraindication for NSAID use in children with asthma exists unless a history of NERD is present.
Conclusions:
- NSAIDs can be recommended for children with known wheeze and asthma.
- Caution is advised for children with a prior history of NSAID-exacerbated respiratory disease (NERD).
- Asthma itself is not an absolute contraindication to NSAID administration in children.
Question:
A child in my clinic who recently sprained his ankle is experiencing pain and having trouble bearing weight on the affected leg. His mother has been giving him acetaminophen, as she was told never to use nonsteroidal anti-inflammatory drugs (NSAIDs) because of his pharmacologically controlled asthma. Is asthma in children a contraindication to giving NSAIDs? Is NSAID-exacerbated respiratory disease (NERD) a real entity?
Answer:
Nonsteroidal anti-inflammatory drugs are effective analgesic and antipyretic medications. While described in adults with some predisposing conditions, NERD has not been clearly described in a large number of children. Nonsteroidal anti-inflammatory drugs can be recommended to children with known wheeze who do not have a history of NERD reaction.
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