CLINICAL PRESENTATION

This is an allergic reaction – hence avoiding allergens help to control

• There is no permanent treatment but adequate control
• There are various types of treatment. and regular evaluation is required by medical professionals to tailor the right treatment.
• Visits should be at least once in 3 months( Unless urgent)
• There are periods where child is better and certain times when its worse
• There are triggers for worsening the wheeze
• Identifying and avoiding these triggers(  See skin testing -below) help to control better
• In babies, wheeze can be caused by viruses( Hence its called virus-induced wheeze)

INVESTIGATIONS

• Asthma is more of a clinical diagnosis assisted with some imaging/ blood test
• Chest X-ray – Your doctor can ask for it, mainly to confirm the diagnosis and rule out other conditions.
• Skin testing- Small amounts of allergy-causing particles are injected into the skin and the allergic reaction is noted.
• Spirometer- child is asked to blow through a tube. Like discussed above, the severe the wheeze(narrower tube) , the less air that can be blown out.

COMMON TRIGGERS( ALLERGENS)

• House dust mites
• Animal fur /pollen
• Smoke/ exercise
• Viral infections

UNDERSTANDING THE TREATMENT

• Good control takes multiple visits to the doctor.
• The treatment should be tailored(Customised) to each child
• The treatment is done in stages(The more frequent the symptoms, the more stronger the treatment)
• The child can be slowly weaned off the treatment and restarted when he develops first symptom( Cough/ breathlessness/ fever)
• The first line of treatment is to reverse the narrowing of tubes in lungs so child can breathe easily.
• Next if to prevent severe symptoms. Since it is most times an allergic reactions, the treatment focuses on using anti allergens( Steroids/ montelukast medication)

There are mostly 2 methods of treatment

• INHALERS-The medication should reach the lungs, hence inhalers are used.
• Oral syrups- like steroid/ anti allergens- takes longer to act but long lasting action.

TREATMENT

Inhalers(Salbutamol or blue inhaler)

Atrovent or Ipratropium brown inhaler

Steroid inhalers

SALBUTAMOL–

• Very fast acting
• Hence first line of treatment
• Dose depending on the age( Ask your doctor)
• Causes hyper excitability. can be given frequently – 4 hourly.
• The doses should be gradually reduced over period of days because the symptoms can rebound otherwise
• Child should carry this always

ATROVENT INHALER

• Can be given simultaneously with salbutamol
• Ask your doctor for dose and frequency

STEROID INHALERS

• Generally prescribed when child has frequent symptoms
• Can be used for months together (like in rainy/ winter seasons where asthma gets worse)

ORAL MEDICATIONS

• Prescribed by your doctor.
• Like oral steroids( For 3-5 days), montelukast( continued for weeks to months)

INJECTIONS/ INFUSIONS

• In hospital setting in severe conditions