Asthma: A Heterogeneous and Challenging Chronic Condition
Asthma is the most common chronic health condition affecting children and a leading cause of emergency department visits and hospitalizations. The diagnosis of asthma can be challenging, but focusing on pertinent aspects of the clinical history can help establish the proper diagnosis. Asthma symptoms can be triggered by exposure to multiple different triggers, which may occur acutely or on a chronic basis. The level of asthma severity and/or control can be readily assessed for all patients and should be utilized to guide treatment. Asthma therapy relies upon the acquisition of self-management skills, use of controller medications for persistent asthma, and avoidance of known triggers. There are multiple types of medications that can be utilized to help control persistent asthma, with inhaled corticosteroids as the mainstay of treatment. Asthma varies considerably in regard to phenotypes, endotypes, severity, and prognosis. This chapter will help identify factors specific to each individual that contribute to the heterogeneity of asthma.
KeywordsAsthma Bronchospasm Controller medications Cough Exacerbations Exercise Inhaler Rescue medications Treatment plan Triggers Wheeze
- 5.Arroyo AJC, Chee CP, Camargo CA Jr, Wang NE. Where do children die from asthma? National data from 2003 to 2015. J Allergy Clin Immunol Pract. 2017. Epub ahead of print in pressGoogle Scholar
- 20.Tang S, Xie Y, Yuan C, Sun X, Cui Y. Fractional exhaled nitric oxide for the diagnosis of childhood asthma: a systematic review and meta-analysis. Clin Rev Allergy Immunol. 2016. Doi: https://doi.org/10.1007/s12016-016-8573-4
- 23.Skinner EA, Diette GB, Alqatt-Bergstrom PJ, Nguyen TT, Clark RD, Makson LE, et al. The asthma therapy assessment questionnaire (ATAQ) for children and adolescents. Dis Manag. 2005;7(14):305–13.Google Scholar
- 27.Cates CJ, Welsh EJ, Rowe BH. Holding chambers (spacers) versus nebulizers for beta-agonist treatment of acute asthma. Cochrane Database Syst Rev. 2013;9:CD000052.Google Scholar
- 33.Chauhan BF, Chartrand C, Ni Chroinin M, Milan SJ, Ducharme FM. Addition of long-acting beta2-agonists to inhaled corticosteroids for chronic asthma in children. Cochrane Database Syst Rev. 2015;11:CD007949.Google Scholar