Managing Medications for Children with Asthma

January 27, 2020
Treating a child’s asthma often requires that they take two types of medication — a quick-relief medication and a maintenance medication, sometimes called controller or long-term control medicine.

Quick-relief Medication

Quick-relief asthma medication often comes in the form of an inhaler that converts liquid medicine to a mist for faster absorption in the airways. It is used on an as-needed basis when a child has asthma symptoms — when you have symptoms, you use the medication when you need it. When you get a bad cough or you experience shortness of breath, you typically use the inhaler multiple times over the course of a few days. Once the symptoms clear up, you can put away the inhaler.
When a child is newly-diagnosed with asthma, the doctor will review the recommendation for medication with the parents, explaining why they are necessary, how they should be taken, what potential side effects are possible, if any, and how the doctor will monitor the child’s progress over time. Parents usually understand the need for the quick-relief medication. It serves the clear, specific purpose of quickly making the child’s breathing easier by reducing muscle tightness around the airways.

Maintenance Medication

Maintenance medication is taken daily to maintain control of the disease, to treat its root causes and to cure the disease. It helps reduce inflammation in the airways and lowers the risk of chronic obstruction. Compared to quick-relief medication, parents tend to have more questions about the need for maintenance medication. They wonder, if the symptoms clear up with the inhaler medication, why does their child need to take another medicine every day when there are no symptoms?
The simplest answer is, because the asthma is still there. In the wake of an asthma attack or flare-up, inflammation of the airways can continue for weeks, even after the symptoms have gone away. With most cases of asthma, at least some degree of inflammation of the airways is present all of the time.
Without maintenance medication, the continuous inflammation can ruin the airways’ surface layer and permanently change the shape of the airways. Permanent scarring of the airways is another consequence of untreated asthma, potentially reducing lung function to where the damage becomes irreversible. Daily maintenance medication is highly effective at preventing these harmful outcomes.
When treatment, including maintenance medications, begins early — as young as 2–3 years old — and has high compliance from the child in terms of taking medications as directed, the likelihood that the child will outgrow the asthma and be cured of it can reach 80% to 90%.

Parents and Treatments

The process of having their young child diagnosed with asthma is a stressful experience for parents. And no parent wants their child to have to take medication on a daily basis. In qualitative research studies involving parents, long-term medication use is an often-mentioned area of concern. That makes it all the more important for parents to voice their concerns and ask questions when discussing their child’s treatment with their doctor, to ensure parents and doctors work toward the same goal for the child’s benefit.
By Dr. Karl Kalavantavanich, a U.S. board certified pediatrician specializing in Pediatric Allergy, Immunology and Pulmonology medicine at Bumrungrad International Hospital 


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