MANAGING CHRONIC MILD ASTHMA: TREATMENT

The preferred medication for mild, intermittent asthma is beta-agonist, as required. It acts quickly, and if inhaled, has relatively fewer adverse effects. However, the administration of this medication in children depends on their age. Mostly children above the age of five years are able to use MDIs (metered-dose inhalers) successfully.
For children below five years, or those who have difficulty with the MDI technique, the use of a spacer device attached to the MDI is recommended. This eliminates the problem of synchronising actuation with inhalation. As mentioned earlier, spacer devices have a holding chamber for medication, and allow children to inhale when they are ready. These problems may vanish as and when MDIs suited the needs of children below five years are developed. At present a device that combines a face mask with a spacer may be used effectively by these children.
Nevertheless, for most children below the age of five years, parents must choose between oral and nebulized medication. Any medicine given through a nebulizer is more effective and has fewer adverse effects, such as tremors and irritability, than when given orally. Nebulized medication is also preferable for children who have infrequent attacks, but are prone nonetheless. Children can take a combination of oral medications, when away from home, and nebulised medication at home.
Medication should be given as soon as the symptoms are first noticed, or if PEFR declines between 10 to 20 per cent. Medicine should be given every 4 to 6 hours until PEFR stabilises or there is fall in the severity of the symptoms.
*101\260\8*

MANAGING CHRONIC MILD ASTHMA:  TREATMENTThe preferred medication for mild, intermittent asthma is beta-agonist, as required. It acts quickly, and if inhaled, has relatively fewer adverse effects. However, the administration of this medication in children depends on their age. Mostly children above the age of five years are able to use MDIs (metered-dose inhalers) successfully.For children below five years, or those who have difficulty with the MDI technique, the use of a spacer device attached to the MDI is recommended. This eliminates the problem of synchronising actuation with inhalation. As mentioned earlier, spacer devices have a holding chamber for medication, and allow children to inhale when they are ready. These problems may vanish as and when MDIs suited the needs of children below five years are developed. At present a device that combines a face mask with a spacer may be used effectively by these children.Nevertheless, for most children below the age of five years, parents must choose between oral and nebulized medication. Any medicine given through a nebulizer is more effective and has fewer adverse effects, such as tremors and irritability, than when given orally. Nebulized medication is also preferable for children who have infrequent attacks, but are prone nonetheless. Children can take a combination of oral medications, when away from home, and nebulised medication at home.Medication should be given as soon as the symptoms are first noticed, or if PEFR declines between 10 to 20 per cent. Medicine should be given every 4 to 6 hours until PEFR stabilises or there is fall in the severity of the symptoms.*101\260\8*

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