Most patients and parents are unclear about the medicines used for treatment of children with asthma. Asthma medicines are of two types: Relievers and Preventers.
Asthma Reliever medicines
Relievers medicines are to be used in only when there are acute symptoms of cough, chest congestion or wheezing and difficulty in breathing. These medicines open up the airway muscles which tighten up during an asthma attack. These are also called as bronchodilators in medical terms. It leads to short lasting benefit only for a few hours. These should not be used for more than 5-7 days and should not be required very often. The usual medicines are salbutamol, levo-salbutamol or terbutaline. These are used in many forms like oral syrups, tablets, nebulizations or inhalers. Most commonly they are used as nebulizers and inhalers are not used as often. It is a very common practice in India for parents to nebulize children with steroids and bronchodilators without prescription. We highly discourage parents or patients to use relievers (nebulizers or inhalers) without consultation with their doctors
Asthma Preventive medicines
The second type of medicine is Preventers. Preventer medicine control the airway swelling in asthma and hence reduce daily symptoms, asthma attacks and keep the child maintain good health and perform all daily activities including good exercise. Preventers should be used daily in prescribed doses for maximum benefit. The commonly used preventive medicines are inhaled steroids like beclomethasone, budesonide or fluticasone. Sometimes combination medicines are also used like budesonide/formetrol or fluticasone/salmetrol. These inhaled steroids in inhaler form are very effective and lead to quick relief of symptoms. These are extremely safe as the doses are very minute (in micrograms) and remain in the child’s airway without entering the body system. Inhalers are therefore the best way to give medicines in asthma.
How asthma medicines should be used?
Preventive medicines are best given with metered dose inhalers or any dry powder inhalers like lupihaler, rotahaler, accuhalers, revolizers, turbhalers etc. In children the best way of giving preventive therapy is to use inhalers with spacers. These are discussed separately. Most children get their preventive inhaler medicines infrequently and keep getting relievers frequently! Rather children should get preventive inhaler regularly and relievers very occasionally.
It is to be remembered that if your child needs relievers frequently then your child is not getting adequate preventer inhaler! The mainstay of treatment in children with asthma is preventers given via inhalers and spacers. If your child has asthma you need to see a pediatric pulmonologist!!