Skip to main content

Treatment of Asthma in Children

  • Chapter
Bronchial Asthma
  • 269 Accesses

Abstract

  • Regularly monitoring peak expiratory flow with peak flow meters is an important part of asthma treatment.

  • Immunotherapy can be beneficial in treating childhood asthma.

  • Anti-inflammatory therapy is the most important pharmacological intervention in treating childhood asthma.

  • Patient education is of utmost importance.

  • With proper anti-inflammatory medications and good patient education, children should be able to lead a normal life, including school attendance and sports.

  • With proper management of childhood asthma, we should be able to significantly decrease asthma mortality.

  • Environmental control should be incorporated into any asthma treatment strategy.

  • Passive exposure to cigarette smoke can negate the beneficial effects of pharmacological treatment of asthma.

  • A total asthma treatment plan should be customized for each asthma patient. This can lead to a decrease in both the indirect and direct costs of treating asthma, and can lead to a decrease in asthma hospitalizations and mortality.

  • Developing optimal technique in the use of metered dose inhalers in children under 12 is difficult. Ongoing instruction and review may be necessary to ensure good technique. Spacers can help as well.

  • Quality of life is an important issue in asthmatic children. Asthma in children should be managed with the goal towards optimizing quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. NHLBI Guidelines for the Diagnosis and Management of asthma. Expert Panel Report 2. National Institutes of Health, National Heart, Lung and Blood Institute. NBIH Publication No. 97–4051, 1997.

    Google Scholar 

  2. Chang CC, Phinney SD, Halpern GM, Gershwin ME. Asthma mortality: another opinion-is it a matter of life and bread? JAsthma 1993; 30: 93–103.

    Article  CAS  Google Scholar 

  3. Spector SI, Nicklas RA. Practice parameters for the diagnosis and treatment of asthma. J Allergy Clin Immunol 1995; 96: 729–731.

    Article  Google Scholar 

  4. Oddy WH, Holt PG, Sly PD, et al. Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study. Br Med J 1999; 310: 815–819.

    Article  Google Scholar 

  5. Van Bever HP, Schuddinck L, Wojciechowski M, Stevens WJ. Aerosolized budesonide in asthmatic infants: a double blind study. Pediatr Pulmonol 1990; 9: 177–180.

    Article  PubMed  Google Scholar 

  6. Mellon M, LeFlein J, Walton-Bowen K, Cruz-Riveira M, Fitzpatrick S, Smith JA. Comparable efficacy of administration with face mask or mouth piece of nebulized budesonide inhalation suspension for infants and young children with persistent asthma. Am J Resp Crit Care Med 2000; 162: 593–598.

    PubMed  CAS  Google Scholar 

  7. Balfour-Lynn L. Growth and childhood asthma. Arch Dis Child 1986: 61: 1049–1055.

    Article  PubMed  CAS  Google Scholar 

  8. Allen DB, Mullen M, Mullen B. A meta-analysis of the effect of oral and inhaled corticosteroids on growth. J Allergy Clin Immunol 1994; 93: 967–976.

    Article  PubMed  CAS  Google Scholar 

  9. Russell G. Childhood asthma and growth: a review of the literature. Respir Med 1994; 88 (Suppl A): 31–37.

    Article  PubMed  Google Scholar 

  10. Chang, CC and Tam AYC. Suppression of adrenal function in children on inhaled steroids. J. Pediatr. Child Health 1991; 27: 232–234.

    Article  CAS  Google Scholar 

  11. Doull IJM, Freezer NG, Holgate ST. Growth of prepubertal children with mild asthma treated with inhaled beclomethasone diproprionate. Am JRespir Crit Care Med 1995; 151: 1715–1719.

    CAS  Google Scholar 

  12. Goldstein DE, Konig P. Effect of inhaled beclomethasone dipropionate on hypothalamic-pituitary-adrenal axis function in children with asthma. Pediatrics 1983; 72: 60–64.

    PubMed  CAS  Google Scholar 

  13. Boorsma M, Andersson N, Larsson P, Ullman A. Assessment of the relative systemic potency of inhaled fluticasone and budesonide. Eur Resp J 1996; 9: 1427–1432.

    Article  CAS  Google Scholar 

  14. Alton E, Norris AA. Chloride transport and the actions of nedocromil sodium and cromolyn sodium in asthma. J Allergy Clin Immunol 1996; 98: S102 - S106.

    Article  PubMed  CAS  Google Scholar 

  15. Taylor IK, O’Shaughnessy KM, Fuller RW, Dullery CT. Effect of cysteinylleukotriene receptor antagonist ICI 204, 219 on allergen-induced bronchoconstriction and airway reactivity in atopic subjects. Lancet 1991; 337: 690–694.

    Article  PubMed  CAS  Google Scholar 

  16. Dahlen SE. Lipid mediator pathways in the lung:leukotrienes as a new target for the treatment of asthma. Clin Exp Allergy 1998; 28 (Suppl 5): 141–146.

    Article  PubMed  CAS  Google Scholar 

  17. Tinkelman DG, Reed CE, Nelson HS, Offord KP. Aerosol beclomethasone dipropionate compared with theophylline as primary treatment of chronic, mild to moderately severe asthma in children. Pediatrics 1993; 92: 64–77.

    PubMed  CAS  Google Scholar 

  18. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS. The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients. J Allergy Clin Immunol 1999; 103: 615–621.

    Article  PubMed  CAS  Google Scholar 

  19. Price JF, Warner JO, Hey EN, Turner MW, Soothill JF. A continued trial of hyposensitization of tyrosine-adsorbed Dermatophagoides pteronyssinus antigen in childhood asthma. In vitro aspects. Clin Allergy 1984; 14: 209–219.

    Article  PubMed  CAS  Google Scholar 

  20. Turner MW, Yalcin I, Sooth JF, et al. In vitro investigation in asthmatic children undergoing hyposensitization with tyrosine-adsorbed Dermatophagoides pteronyssinus antigen. Clin Allergy 1984; 14: 221–231.

    Article  PubMed  CAS  Google Scholar 

  21. Van Bever HP, Stevens WJ. Evolution of the late asthmatic reaction during immunotherapy and after stopping immunotherapy. JAllergy Clin Immunol 1990; 86: 141–146.

    Article  Google Scholar 

  22. Valovirta E, Viander M, Koivikko A, Vanto T, Ingeman L. Immunotherapy in allergy to dog: immunologic and clinical findings of a double-blind study. Ann Allergy 1986; 57 (3): 173–179.

    PubMed  CAS  Google Scholar 

  23. Hedlin G, Graff-Lonnevig V, Heilborn H, et al. Immunotherapy with cat-and dog-dander extracts. V. Effects of 3 years of treatment. J Allergy Clin Immunol 1991; 87: 955–964.

    Article  PubMed  CAS  Google Scholar 

  24. Hedlin G, Graff-Lonnevig V, Heilborn H, et al. Immunotherapy with cat-and dog-dander extracts. II. In vivo and in vitro immunologic effects observed in a 1-year double-blind study. J Allergy Clin Immunol 1986; 77: 488–496.

    Article  PubMed  CAS  Google Scholar 

  25. Horst, M, Hejjaoui A, Horst V, Michel FB, Bousquet J. Double-blind placebo-controlled rush immunotherapy with a standardized Alternaria extract. J Allergy Clin Immunol 1990; 85: 460–472.

    Article  PubMed  CAS  Google Scholar 

  26. Dreborg S, Agrell B, Foucard T, Kellman NIM, Koivikko A, Nilsson S. A double-blind multicenter immunotherapy trial in children using a purified and standardized Cladosporium herbarium preparation. I. Clinical results. Allergy 1986; 41: 131–140.

    Article  Google Scholar 

  27. Frankland AW, Augustin R. Prophylaxis of summer hayfever and asthma: controlled trial comparing crude grass pollen extracts with isolated main protein component. Lancet 1954; 1: 1055–1057.

    Article  Google Scholar 

  28. Johnstone DR. Study of the role of antigen dosage in the treatment of pollenosis and pollen asthma. J Dis Child 1957; 94: 1–5.

    CAS  Google Scholar 

  29. Gaddie J, Skinner C, Palmer KNV. Hyposensitization with house dust mite vaccine in bronchial asthma. Br Med J 1976; 561: 2–11.

    Google Scholar 

  30. Lilja G, Sundin B, Graff-Lonnevig V, et al Immunotherapy with cat and dog dander extracts. Effects of two years of treatment. J Allergy Clin Immunol 1989; 83: 37–44.

    Article  PubMed  CAS  Google Scholar 

  31. Hill DJ, Hosking CS, Shelton MJ, Turner MW. Failure of hyposensitization in treatment of children with grass-pollen asthma. Br Med J 1982; 284: 306–314.

    Article  CAS  Google Scholar 

  32. Bosquet J, Hejjaoui A, Clauzel AM, et al. Specific immunotherapy with a standardized Dermatophagoides pternoyssinus extract. II. Prediction of efficacy of immunotherapy. J Allergy Clin Immunol 1988; 82: 971–977.

    Article  Google Scholar 

  33. Charlesworth EN, Massey WA, Kagey-Sobotka A, Norman PS, Lichtenstein LM. Effect of H1 receptor blockade on the early and late phase response to cutaneous allergen challenge. J Pharmacol Exp Ther 1992; 262: 964–970.

    PubMed  CAS  Google Scholar 

  34. Rosenthal RR, Campbell J, Norman PS. The protective effects of inhaled terbutaline and isoproterenol on exercise induced bronchospasm. Am Rev Respir Dis 1979; 119(Suppl): 79(Abstract).

    Google Scholar 

  35. Konig P, Hordvik NL, Serby CW. Fenoterol in exercise-induced asthma: effect of dose on efficacy and duration of action. Chest 1984; 85: 462–464.

    Article  PubMed  CAS  Google Scholar 

  36. Walker SB, Bierman CW, Pierson WE, Shapiro GG, Furukawa CT, Mingo TS. Bitolterol mesylate in exercise-induced asthma. J Allergy Clin Immunol 1986; 77: 32–36.

    Article  PubMed  CAS  Google Scholar 

  37. Newnham D, Ingram C, Earnshaw J, et al. Duration of action of inhaled salmeterol against exercise induced asthma. Am Rev Respir Dis 1991; 143: A29 (Abstract).

    Google Scholar 

  38. Green CP, Price JF. Prevention of exercise induced asthma by inhaled salmeterol xinafoate. Arch Dis Child 1992; 67: 1014–1017.

    Article  PubMed  CAS  Google Scholar 

  39. Francis PW, Krastins IR, Levison H. Oral and inhaled salbutamol in the prevention of exercise-induced bronchospasm. Pediatrics 1980; 66: 103–108.

    PubMed  CAS  Google Scholar 

  40. Sly RM, O’Brien SR. Effect of oral terbutaline on exercise-induced asthma. Ann Allergy 1982; 48: 151–155.

    PubMed  CAS  Google Scholar 

  41. Patel KR, Wall RT. Dose duration effect of sodium cromoglycate aerosol in exercise-induces asthma. Eur J Respir Dis 1986; 69: 256–260.

    PubMed  CAS  Google Scholar 

  42. Debelic M. Nedocromil sodium and exercise-induced asthma in adolescents. Eur J Respir Dis 1986; 69 (Suppl 147): 266–267.

    Google Scholar 

  43. Merland N, Cartier A, L’Archeveque J, Ghezzo H, Malo JL. Theophylline minimally inhibits bronchoconstriction induced by dry cold air inhalation in asthmatic subjects. Am Rev Respir Dis 1988; 137: 1304–1308.

    PubMed  CAS  Google Scholar 

  44. Thomson NC, Patel KR, Kerr JW. Sodium cromoglycate and ipratropium bromide in exercise-induced asthma. Thorax 1978; 33: 694–699.

    Article  PubMed  CAS  Google Scholar 

  45. Makker HK, Lau LC, Thomson, HW, et al. The protective effect of inhaled leukotriene D4 receptor antagonist ICl204, 219 against exercise-induced asthma. Am Rev Respir Dis 1993; 147: 1413–1418.

    PubMed  CAS  Google Scholar 

  46. Robuschi M, Riva E, Fucella LM, et al. Prevention of exercise-induced bronchoconstriction by a new leukotriene antagonist (SKandF 104353). A double-blind study versus disodium cromoglycate. Am Rev Respir Dis 1992; 145: 1285–1288.

    PubMed  CAS  Google Scholar 

  47. Finnerty JP,Wood-Baker R, Thomson H, Holgate ST. Role of leukotrienes in exercise-induced asthma Inhibitory effect of ICI 204219, a potent leukotriene D4 receptor antagonist. Am Rev Respir Dis 1992; 145: 746–749.

    Google Scholar 

  48. Makker HK, Lau LC, Thomson HW, Binks SM, Holgate ST. The protective effect of inhaled leukotriene D4 receptor antagonist ICI-204,219 against exercise-induced asthma. Am Rev Respir Dis 1993; 147: 1413–1418.

    PubMed  CAS  Google Scholar 

  49. Tanser AR, Elmes J. A controlled trial of ketotifen in exercise-induced asthma. Br J Dis Chest 1980; 74: 398–402.

    Article  PubMed  CAS  Google Scholar 

  50. Barnes PJ, Wilson NM, Brown MJ. A calcium antagonist, nifedipine, modifies exercise-induced asthma. Thorax 1981; 36: 726–730.

    Article  PubMed  CAS  Google Scholar 

  51. Patel KR. Calcium antagonists and exercise-induced asthma. Br Med J 1981; 282: 932–933.

    Article  CAS  Google Scholar 

  52. Foresi A, Corbo GM, Ciappi G, Valente S, Polidori G. Effect of two doses of inhaled diltiazem on exercise-induced asthma. Respiration 1987; 51: 241–247.

    Article  PubMed  CAS  Google Scholar 

  53. Zielinski J, Chodosowska E. Exercise-induced bronchoconstriction in patients with bronchial asthma: its prevention with an antihistaminic agent. Respiration 1977; 34: 31–35.

    Article  PubMed  CAS  Google Scholar 

  54. Englund JA. Prevention strategies for respiratory syncytial virus: passive and active immunization. J Pediatr 1999; 135: 38–44.

    PubMed  CAS  Google Scholar 

  55. McBride JT. Pulmonary function changes in children after respiratory syncytial virus infection in infancy. J Pediatr 1999; 135: 28–32.

    Article  PubMed  CAS  Google Scholar 

  56. Busse WW, Lemanske RF Jr, Stark JM, Calhoun WJ. The role of respiratory infections in asthma, in Asthma: Physiology, Immunopharmacology and Treatment. ( Holgate ST, Austen KF, Lichtenstein LM, Kay AB, eds.), Academic, London. 1993; pp. 345–353.

    Google Scholar 

  57. Johnston SL, Pattemore PK, Sanderson G, et al. Community study of role of viral infections in exacerbations of asthma in 9 to 11 year old children. BMJ 1995; 310: 1225–1229.

    Article  PubMed  CAS  Google Scholar 

  58. Kang BC. Cockroach allergy. Clin Rev Allergy 1990; 8: 87–98.

    PubMed  CAS  Google Scholar 

  59. Shapiro GG, Wighton TG, Chinn T, et al. House dust mite avoidance for children with asthma in homes of low-income families. J Allergy Clin Immunol 1999; 103: 1069–1074.

    Article  PubMed  CAS  Google Scholar 

  60. Taylor SI, Bush RK, Seiner JC, et al. Sensitivity to sulfited foods among sulfite-sensitive subjects with asthma. JAllergy Clin Immnol 1988; 81: 1159–1167.

    Article  CAS  Google Scholar 

  61. Davis PA, Chang C, Hackman RM, Stern JS, Gershwin ME. Acupuncture in the treatment of asthma: a critical review. Allergol. Et. Immunopathol (Madr.) 1998; 26: 263–271.

    CAS  Google Scholar 

  62. Strachan DP. The epidemiology of childhood asthma. Allergy 1999; 54 (Suppl 49): 7–11.

    Article  PubMed  Google Scholar 

  63. Lupinetti MD, Sheller JR, Catella F, Fitzgerald GA. Thromboxane biosynthesis in allergen-induced bronchospasm: evidence for platelet activation during exercise induced asthma. Am Rev Respir Dis 1989; 140: 932–935.

    PubMed  CAS  Google Scholar 

  64. Wilkins JH, Wilkins H, Uffman J, et al. Effects of PAF antagonist (BN52063) on bronchoconstriction and platelet activation during exercise induced asthma. Br J Clin Pharmacol 1991; 29: 85.

    Article  Google Scholar 

  65. Coyle AJ, Page CP, Atkinson L, Sjoerdsma K, Touvay C, Metzger WJ. Modification of allergen-induced airway obstruction and airway hyperresponsiveness in allergic rabbit model by the selective platelet-activating factor antagonist, BN52021. J Allergy Clin Immunol 1989; 84: 960–967.

    Article  PubMed  CAS  Google Scholar 

  66. Knauer KA, Lichtenstein LM, Adkinson NF Jr, Fish JE. Platelet activation during antigen-induced airway reactions in asthmatic subjects. N Engl J Med 1981; 304: 1404–1407.

    Article  PubMed  CAS  Google Scholar 

  67. Szczeklik A, Schmitz-Schumann M, Krzanowski M, Virchow C Sr. Delayed generation of thrombin in clotting blood atopic subjects with hay fever and asthma. Clin Exp Allergy 1991; 21: 411–415.

    Article  PubMed  CAS  Google Scholar 

  68. Chihara J, Fukuda K, Yasuba H, et al. Platelet factor 4 enhances eosinophil IgG and IgE Fc receptor and has eosinophil chemotactic activity. Am Rev Respir Dis 1988; 137: 412A.

    Google Scholar 

  69. Deuel TRF, Huang JS. Platelet-derived growth factor: structure, function and roles in normal and transformed cells. J Clin Invest 1984; 74: 669–676.

    Article  PubMed  CAS  Google Scholar 

  70. Ross R, Raines EW, Bowen-Pope DF. The biology of platelet-derived growth factor. Cell 1986; 46: 155–169.

    Article  PubMed  CAS  Google Scholar 

  71. Roberts AB, Sporn MB, Assoian RK, et al. Transforming growth factor type beta: rapid induction of fibrosis and angiogenesis in vivo and stimulation of collagen formation in vitro. Proc Natl Acad Sci USA 1986; 83: 4167–4171.

    Article  PubMed  CAS  Google Scholar 

  72. Kameyoshi Y, Dorschner A, Mallet AI, Christophers E, Schroder JM. Cytokine RANTES released by thrombin-stimulated platelets is a potent attractant for human eosinophils. J Exp Med 1.992; 176: 587–592.

    Google Scholar 

  73. Tsicopoulos A, Lassalle P, Joseph M, et al. Effect of disodium cromoglycate on inflammatory cells bearing the Fc epsilon receptor Type II (FcRII). Int J Immunopharmacol 1988; 10: 227–236.

    Article  PubMed  CAS  Google Scholar 

  74. Thorel T, Joseph M, Tsicopoulos A, Tonnel AB, Capron A. Inhibition by nedocromil sodium of IgE-mediated activation of human mononuclear phagocytes and platelets in allergy. Int Arch Allergy Appl Immunol 1988; 85: 232–237.

    Article  PubMed  CAS  Google Scholar 

  75. De Vos C, Joseph M, Leprevost C, et al. Inhibition of human eosinophil chemotaxis and of IgE-dependent stimulation of human blood platelets by cetirizine. Int Arch Allergy Appl Immunol 1989; 88: 212–215.

    Article  PubMed  Google Scholar 

  76. Ricci M, Matucci A, Rossi O. New advances in the pathogenesis and therapy of bronchial asthma. Ann Ital Med Int 1998; 13: 93–110.

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Chang, C. (2001). Treatment of Asthma in Children. In: Gershwin, M.E., Albertson, T.E. (eds) Bronchial Asthma. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-127-5_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-127-5_7

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-4687-7

  • Online ISBN: 978-1-59259-127-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics