Pre-School Wheeze in Children

Question 1

What % of children have an episode of wheeze before 18 months?

Answer 1

25%

Question 2

What are the 2 types of pre-school wheeze in children?

Describe them.

Answer 2

• Episodic viral wheeze: only wheezes with a viral URTI and symptom free in between.
• Multiple trigger wheeze: multiple factors cause wheeze. (e.g. URTI, exercise, allergens, cigarette smoke.

Question 3

Which wheeze is more likely to develop asthma in later life?

Answer 3

Multiple trigger wheeze.

Question 4

How do you manage episodic viral wheeze?

Answer 4

• Treatment is symptomatic only
• First-line is treatment with short acting beta 2 agonists (e.g. salbutamol) or anticholinergic via a spacer
• Next step is intermittent leukotriene receptor antagonist (montelukast), intermittent inhaled corticosteroids, or both.
• There is now thought to be little role for oral prednisolone in children who do not require hospital treatment.

Question 5

How should you manage multiple trigger wheeze?

Answer 5

Trial of either inhaled corticosteroids or Monteleukast for 4 to 8 weeks.

Question 6

In all children with wheeze, what should you advise their parents to do?

Answer 6

Stop smoking.