Pharmacotherapy of Asthma in Preschool-aged Children
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Abstract
Asthma is disease characterized by chronic airway inflammation. Most of patients were diagnosed in childhood age, especially preschool-age or younger than 5 years old. A diagnosis of asthma in this age group is difficult because recurrent wheezing occurs in a large proportion and reproducible expiratory maneuvers or other physiologic lung function testing cannot be performed with patient co-operation. Diagnosis of asthma in preschool-aged children, therefore, is based on symptoms appearing during exercise, laughing or crying with the absence of an apparent of respiratory infection; a history of other allergic disease or asthma history in first-degree relatives; clinical response to medications for controlling asthma.
There are 2 major groups of asthma medications in preschool aged children including inhaled short-acting beta2-agonist such as salbutamol for relieving during asthma attack, and long term controllers of symptoms such as inhaled corticosteroid and leukotriene receptor antagonist. Selection of controllers is based on symptom pattern including severity and frequency of asthma, symptom control, and patient age. These factors affect the choice of inhaler device. Furthermore, assessment, adjustment and review of treatment response should be done periodically through a partnership between the parents/care givers and the multi-disciplinary health team to achieve the goal of asthma management.
Acute asthma exacerbation is the emergency medical condition that patient needs urgent care. Parents/care givers should recognize symptoms on attack, provide basic treatment with bronchodilators, assess the response to bronchodilators and take the patient to the nearest hospital. Physicians in the primary care setting assess the patient’s severity, initiate treatment with oxygen, bronchodilators, systemic corticosteroid and/or magnesium sulfate, and also consider transferring the patient to the critical care setting for respiratory support and further appropriate management.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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