What to do about bronchial asthma in children

Bronchial asthma has always been a stubborn disease that is difficult to cure, and the medical community has not yet produced a specific medicine. So, what should we do about bronchial asthma? Especially for adolescents and children, treatment methods and means need to be more cautious. Today, let’s take a look at how experts explain bronchial asthma in children.

Asthma is a heterogeneous disease characterized by chronic airway inflammation; presenting with a history of respiratory symptoms of wheezing, shortness of breath, chest tightness, and cough, with variable expiratory airflow limitation, which can vary in intensity over time. Asthma can occur at any age, but most cases begin before the age of 4 to 5 years. Active prevention and treatment of pediatric bronchial asthma can prevent irreversible airway stenosis and airway remodeling.

1. Treatment principles

Asthma control treatment should be started as early as possible. We must adhere to the principles of long-term, continuous, standardized and individualized treatment. Treatment includes: ① Acute attack period: rapid relief of symptoms, such as antiasthmatic and anti-inflammatory treatment; ② Chronic persistent period and clinical remission period: preventing symptom aggravation and recurrence, such as avoiding triggering factors, anti-inflammatory, reducing airway hyperresponsiveness, preventing airway remodeling, and doing a good job of self-management. Emphasis should be placed on the combination of drug treatment and non-drug treatment, and the role of non-drug treatments in the long-term management of asthma, such as asthma prevention and treatment education, allergen avoidance, treatment of psychological problems in children, improvement of quality of life, and pharmacoeconomics, should not be neglected.

2. Treatment of acute asthma attacks

(1) β2 receptor agonists β2 receptor agonists are the most widely used bronchodilators in clinical practice. Depending on how fast they take effect, they can be divided into rapid-acting and slow-acting categories; depending on how long they last, they can be divided into short-acting and long-acting categories. The efficacy of inhaled rapid-acting β2 receptor agonists can last for 4 to 6 hours, and it is the first choice drug for relieving acute symptoms of asthma. During a severe asthma attack, it can be inhaled once every 20 minutes in the first hour, and then repeatedly every 2 to 4 hours. Drug dosage: 2.5-5.0 mg of salbutamol or 2.5-5.0 mg of terbutaline each time. When the acute attack is relatively mild, short-term oral short-acting β2 receptor agonists such as salbutamol tablets and terbutaline tablets can also be chosen.

(2) Systemic glucocorticoids: Acute cases with more severe conditions should be treated with short-term oral prednisone (1 to 7 days), 1 to 2 mg/kg per day, divided into 2 to 3 doses. Long-term use of oral corticosteroids for the treatment of asthma in children is generally not recommended. In severe asthma attacks, methylprednisolone should be given intravenously at 2 to 6 mg/kg per day, divided into 2 to 3 infusions, or hydrocortisone succinate or hydrocortisone, 5 to 10 mg/kg each time. The dose can be increased if necessary. Generally, intravenous glucocorticoids are used for 1 to 7 days, and intravenous medication is stopped after symptoms are relieved. If continuous use of glucocorticoids is required, oral prednisone can be used instead.

(3) Anticholeretic drugs: Inhaled anticholeretic drugs such as ipratropium bromide have a weaker bronchodilating effect than β2 receptor agonists and a slower onset of action, but long-term use is less likely to lead to drug resistance and has fewer adverse reactions.

Children with bronchial asthma require better care and attention from parents, especially to avoid excessive and strenuous exercise. At the same time, you should be more careful when seasons change or when you encounter allergens. It is recommended that you do not lose your mind when faced with various false advertisements for the treatment of bronchial asthma, and try to choose regular hospitals for treatment and examination.