management of asthma in children

Question 1

What is the treatment for children with asthma

Answer 1

Start on low dose ICS and then review after 2 months

Then add on long acting beta agonist for children over 5 and if they are under 5 a leukotrine receptor agonist

Then increase ICS

Daily steroid tablet is the last option

Question 2

When to increase from stage 1 to stage 2 treatment

Answer 2

Using SABA more than 2 days a week

or

Symptomatic 3x a week or waking up 1x a week

Question 3

What to remember when prescribing long acting beta agonist

Answer 3

Do not use without an ICS and use a fixed dose inhaler

Question 4

how much better is a spacer compared to without

Answer 4

20% lung deposition of drug with a spacer compared to 5% without

Question 5

What to do when using spacer

Answer 5

Shake the inhaler in between puffs and wash the spacer monthly to reduce static

Question 6

What age are dry powder devices allowed

Answer 6

> 8 years old

Question 7

What is the treatment of mild acute asthma

Answer 7

SABA with a spacer - can add prednisolone as well

Question 8

What is the treatment of moderate acute asthma

Answer 8

SABA with nebuliser and prednisolone

Question 9

What is the treatment of severe acute asthma

Answer 9

IV salbutamol
IV aminophylline
IV magnesium
IV hydrocortisone
Intubate the patient and ventilate them

Question 10

What is the difference with steroids in acute asthma compared to chronic

Answer 10

The steroids are oral for acute

Question 11

What should be used to guide acute asthma management

Answer 11

Oxygen sats