Treatment of asthma in children

 


Tests and Diagnosis:


 Asthma is often diagnosed based on the health history of family members, presence of symptoms, and physical exams.


 Often times when you take your child to the doctor for a checkup, asthma symptoms may not be present at that point.  Therefore, it is not possible to rely only on the doctor’s examination, but also on the help of parents and explanation to the doctor about all the symptoms and changes that occur with the child at different times.


 Health history:


 Whether there is a previous case of asthma in the family, or various respiratory or allergic problems, such as eczema, rashes, or various lung diseases.


 If you notice any of the following symptoms with your child, they should be described to the doctor: Whether coughing, wheezing, shortness of breath, or chest pain, in detail.  For example, times when symptoms increase.


 Physical examinations:


 The doctor listens to the sound of the heart and lungs and detects the presence of allergic symptoms in the nose or eyes


 Chest x-ray:


 For children aged five years and over.


 Spirometry (checking the respiratory rate):


 Simple lung function test.  It measures the amount of air in the lungs and the level of exhalation speed.  The results of this test help the doctor determine the severity of asthma, and this test may be performed when the child reaches the age of five or older.


 Exhaled nitric oxide test:


 It is an indication of the presence of inflammation in the airways (FeNO). The higher the level of nitric oxide in the exhaled air, the more this indicates the weakening of the lungs' ability to work properly, and the higher the degree of inflammation in the airways.  This test can also be done when the child is five years old or over.


 Allergy test (identification of substances that trigger asthma attacks):


 This test includes blood tests and subcutaneous allergy tests.


 Impulse oscillometry:


 This test is performed for older children, but for infants with asthma, it is often based on health history and genetics only.


 Peak air flow meter:


 It is an easy-to-carry, manual device that measures how well the lungs are working.  And the highest flow of exhaled air and its speed.  Lower readings indicate worsening asthma, and the higher the readings, the better the patient's health.


 By following these readings, parents and children can know the extent of asthma attacks receding before symptoms occur, and thus it is possible to avoid this with appropriate treatment before the patient’s condition is dissatisfied.


 Asthma treatment:


 Asthma cannot be cured completely, but it can be controlled and controlled.  The goal is:


 Control and control of symptoms. Reducing the risk of future asthma exacerbation. Maintaining effective lung function. Being able to perform normal activities. Using the least amount of medication possible with the least possible amount of side effects.


 Treatment varies according to the severity of asthma, the patient’s age and health.


 Asthma medications are divided into the following sections:


 Long-term asthma medications:


 These are fixed medications that are used daily in the long term to control the permanent condition of asthma.  These medications may be used seasonally if asthma symptoms get worse at certain times of the year.


 These medications include the following types:


 Corticosteroid inhalation:


 It is the most common type of asthma control.  These anti-inflammatory drugs include: fluticasone, budesonide, beclometasone, and mometasone.


 Leukotriene modifiers:


 They are considered the second additional treatment with inhaled corticosteroids.  These include: montelukast, zaverlukast, xyloton.


 In rare cases, the combined treatment of Montelukast and Xyloton may cause psychological reactions such as aggression, hallucinations or depression.  If you feel the presence of these changes in your baby when you share the two medicines together, you should see the doctor.


 Pharmacological combination of multiple asthma inhalers:


 These medicines contain slow-acting beta-agonist corticosteroids.  These drugs include: combination of fluticasone with salmeterol, combination of budesonide with formoterol, and mometasone combination with formoterol.  This participation prevents severe asthma attacks.


 Theophylline:


 This daily medicine opens the airways (bronchodilator).


 Fast-acting asthma medications:


 They are fast-acting bronchodilators that provide the body with an immediate effect for treating the symptoms of acute asthma attacks, and the effect lasts from 4-6 hours.


 Among the most common drugs in this category we mention Albuterol, and among the drugs that are also used are pirbuterol and levalbuterol.


 Although the effect of these drugs is fast acting, they do not prevent the symptoms from returning.  If your child has frequent asthma attacks, he needs to take long-acting asthma medications such as asthma steroid sprays to control asthma and relieve symptoms.


 If your child needs to take fast-acting asthma medication most of the time, this means that his asthma is not under control.


 Immunotherapy for allergic asthma (allergic asthma):


 Immunotherapy is useful for controlling allergic asthma that cannot be controlled by avoiding the allergens.


 The increased sensitivity of the immune system causes swelling of the lungs and airways and the production of sputum upon exposure to allergens.  Reactions to the allergens may be delayed, which may make it difficult for the body to recognize the allergen.


 Immunotherapy is based on the following:


 Your child will begin to have subcutaneous tests, to determine the type of allergen that causes his allergic asthma to worsen.


 After the type of allergen is recognized, the patient receives a series of injections containing small doses of these allergens.  Your child may need to have the injection once a week for several months, and then one injection every month for 3-5 years.  The allergic reactions in your child and the symptoms of asthma should gradually disappear.


 Asthma devices:


 Most asthma treatments are given by means of a machine that allows the patient to inhale the drug and deliver it directly to the lungs.  These devices include the following types:


 The metered dose inhaler is a small, easy-to-hold device that is one of the most popular types of use for asthma medication.  To make sure your child gets the correct dose, he may need to use a vacuum tube that hangs on the inhaler. Dry powder inhalers: There are certain types of asthma medicines your child may need to use in the form of dry powders.  This device requires a quick, deep inhalation to get the full dose of the medicine. Nebulizer: A nebulizer turns a medicine into a fine mist that your child inhales through a face mask.  These inhalers can deliver higher doses of the drug into the lungs at a higher rate than inhalers.


 For young children, the child often needs to use nebulizers because it is difficult for them to use other inhalers.  Childhood asthma is one of the most common reasons children miss school.  May disrupt sleep, play and other activities.

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