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Langwerkende β 2-mimetica bij de behandeling van astma bij kinderen

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Tijdschrift voor kindergeneeskunde

Summary

Two long-acting inhaled β 2-agonists are currently available for the treatment of childhood asthma. Compared to short-acting b 2-agonists, formoterol and salmeterol have a longer duration of action, which is at least 12 hours for the bronchodilating effect. Although during continuous treatment tolerance will develop, especially for the protecting effects, residual protection remains even during long-term treatment. Formoterol and salmeterol should only be used in combination with inhaled corticosteroids in children with moderate to severe asthma, who do have persisting symptoms despite beclomethason or budesonide 400-800 μg daily or fluticason 250-500 μg daily. For every single patient it should be decided which is more appropriate: the addition of a long-acting β 2-agonist or increasing the dose of inhaled corticosteroid.

Samenvatting

Twee langwerkende inhalatie-β 2-sympaticomimetica, formoterol en salmeterol, zijn de laatste jaren beschikbaar gekomen voor de behandeling van astma bij kinderen. Ten opzichte van kortwerkende β 2-sympaticomimetica onderscheiden zij zich door hun lange werkingsduur; voor wat het bronchusverwijdende effect is dit tenminste 12 uur. Hoewel tijdens continu gebruik een zekere tolerantie optreedt, blijven significante beschermende effecten ook bij langdurig gebruik bestaan. Deze middelen kunnen in combinatie met inhalatiesteroïden worden gebruikt bij kinderen met matig ernstig tot ernstig astma. Bij persisteren van astmaklachten ondanks onderhoudsbehandeling met inhalatiesteroïden in een dosering van 400-800 μg beclometason of budesonide of 250-500 μg fluticason per dag, dient gekozen te worden voor hetzij verhoging van de dosering inhalatiesteroïden hetzij de toevoeging van een langwerkend β 2-sympaticomimeticum.

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    A. A. P. H. Vaessen-Verberne

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  1. A. A. P. H. Vaessen-Verberne
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Mevr. A.A.P.H. Vaessen-Verberne, kinderarts, Ignatius Ziekenhuis, afd. kindergeneeskunde, Postbus 90158, 4800 rk Breda.

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Vaessen-Verberne, A.A.P.H. Langwerkende β 2-mimetica bij de behandeling van astma bij kinderen. KIND 68, 135–138 (2000). https://doi.org/10.1007/BF03061296

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