Asthma in Children Flashcards
If a child is under 5, descibe the stepwise process of treating them. (BTS 2014)
- SABA
- Inhaled Corticosteroid 200-400mcg
- If 2-5 years, trial of leukotriene receptor antagonist.
- If <2 years then refer to Respiratory Paediatrician.
1. Refer to Respiratory Paediatrician.
If a child is over than 5 years, how would you control their asthma in a stepwise manner. (BTS 2014) (At this point it is very similar to adults)
- SABA
- ICS 200-400mcg (Adult is 200-800mcg)
- LABA
- Review - if no response to LABA then stop.
- Increase ICS up 800mcg/day (ADULT IS 2000mcg/day)
- Use daily steroid tablet at lowest dose providing control
- Mantain ICS at 800mcg/day and Refer to a Respiratory Paediatrician.
How do you treat a child with viral induced wheeze but no interval symptoms?
SIGN suggests watchful waiting with review in children with mild, intermittent wheeze and other respiratory symptoms which occur only with viral upper respiratory tract infections.
In these cases it is often reasonable to give no specific treatment and to plan a review of the child after an interval agreed with the parents/carers to guide further investigations and/or treatment.
What are some features that reduce the chance of an asthma diagnosis?
- Symptoms with colds (coryzal illness) only.
- Isolated cough in the absence of wheeze or difficulty breathing.
- History of moist cough.
- Prominent dizziness, light-headedness, peripheral tingling.
- Clinical features pointing to an alternative diagnosis.
- Repeatedly normal physical examination of the chest when symptomatic.
What are some features that increase the posibility of the diagnosis of asthma?
- Frequent and recurrent.
- Worse at night & early morning.
- Worse after, exercise or other triggers such as exposure to pets, cold or damp air, or with emotions or laughter.
- Personal history of atopy (hayfever, eczema).
- FH of asthma and/or atopic disorder.
- There is prolonged expiration or an increased respiratory rate.
