Related Experiment Video
Updated: Jun 11, 2025
Dry Powder and Nebulized Aerosol Inhalation of Pharmaceuticals Delivered to Mice Using a Nose-only Exposure System
Published on: April 6, 2017
Pharmacological Management of Pediatric Critical Asthma
Colin M Rogerson1, Benjamin R White2, Samer Abu-Sultaneh1
1Drs. Rogerson and Abu-Sultaneh are affiliated with the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.
Insights
Pediatric critical asthma, a severe form of childhood asthma, requires prompt treatment. This review examines evidence for adjunctive therapies beyond initial treatments for better outcomes in children.
Area of Science:
- Pediatric Emergency Medicine
- Pulmonology
- Critical Care
Background:
- Pediatric critical asthma (formerly status asthmaticus) is a frequent emergency department and PICU admission.
- Initial treatment involves systemic corticosteroids and inhaled bronchodilators.
Purpose of the Study:
- To review current evidence on adjunctive therapies for pediatric critical asthma.
- To identify research gaps in the management of severe pediatric asthma.
Main Methods:
- Narrative review of existing literature.
- Synthesis of evidence on adjunctive medications.
Main Results:
- Adjunctive therapies include inhaled anticholinergics, ketamine, magnesium, short-acting β2 agonists, and methylxanthines.
- Evidence for these therapies in pediatric populations is summarized.
Conclusions:
- Further research is needed to optimize adjunctive treatment strategies for pediatric critical asthma.
- Understanding evidence gaps can guide future clinical practice and research.
Abstract:
Pediatric critical asthma, formerly known as status asthmaticus, is a common pediatric condition encountered in emergency departments, hospital wards, and PICUs. Systemic corticosteroids and inhaled bronchodilators are evidence-based, initial treatments for patients with pediatric critical asthma. If clinical symptoms do not improve, then pediatric practitioners often prescribe adjunctive medications, including inhaled anticholinergics, intravenous ketamine, intravenous magnesium, intravenous short-acting β2 agonists, and intravenous methylxanthines (eg, aminophylline). In this narrative review, we summarize the current evidence and present the research gaps related to these therapies in the pediatric population.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:17Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:24Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...