Doc Talk: Asthma

In our new weekly feature, Doc Talk, we sit down with pediatric emergency doctor, Clint Pollack from Valley Children's Hospital to discuss one of the most common conditions in Valley kids -- asthma.

How common is asthma and when does it typically develop?

- One of the most common chronic pediatric diseases, affecting up to 20% of children in some areas.

- Usually develops in children under 5 years-old.

- Can be associated with eczema and food allergies.

Is there anyone who's more prone to getting it?

- Children of parents with asthma are 2-5 times more likely to develop asthma.

What are some symptoms and triggers?

- Cough is the most common symptom and occurs especially at night, seasonally, and for prolonged periods of time (greater than 3 weeks).

- Wheezing often accompanies the cough and is caused by narrowing of small tubes in the lungs.

- Most common triggers include viral upper respiratory infections, seasonal allergens such as pollen or mold, smoke, cold air, and exercise.

How is it treated?

- Asthma is treated using bronchodilators and may also include allergy medicine and steroids.

- Relax the muscles that constrict the tubes in the lungs.
- Most important medicine for treating asthma. Should be given every four hours if your child is having asthma symptoms.
Albuterol (Proair, Ventolin) or levalbuterol (Xopenex).

- Can be given with an inhaler (MDI) or nebulizer. Both are equally effective. The inhaler should always be used with an aerochamber (spacer), even with older children or adults, as it delivers more medicine to the lungs.

What can be used to decrease symptoms that come with it?

Allergy medicines are used to decrease allergic symptoms that may trigger asthma and may include loratadine (Claritin), cetirizine (Zyrtec), or montelukast (Singulair).

Steroids are very important for treating persistent asthma or severe asthma attacks.

Steroids are anti-inflammatory and reduce swelling and secretions in the lungs.

For persistent asthma, inhaled steroids must be taken every day. These medicines are weak (to minimize long term side effects) and will not work unless taken every day. Beclomethasone (Qvar) and budesonide (Pulmicort) are common inhaled steroids.

For severe attacks, a short course (usually 5-7 days) of stronger steroids are used. These medicines may include prednisone or dexamethasone and are taken by mouth.

Persistent asthma is defined as daytime symptoms more than twice per week or nighttime symptoms more than twice per month.

If your child is having asthma symptoms (cough, wheeze, chest tightness), give albuterol every four hours. If symptoms last more than a few days or are worsening, see your pediatrician. If your child is having difficulty breathing (shortness of breath, retractions, head-bobbing, unable to speak in full sentences) go to the emergency room or call 911.
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