Childhood Asthma Treatment

Asthma is a serious risk to human health, respiratory diseases, such as failure to obtain timely and reasonable treatment. Pediatric patients often develop adult asthma; or development of emphysema and pulmonary heart disease and even cause death. Nearly 10 years, the incidence of the disease mechanisms of a correct understanding of new and more effective asthma drugs have been commissioned. The treatment of the disease with the fundamental changes that have bronchial asthma prognosis greatly changed. Pediatric asthma positively reasonable treatment, the majority can be radical. (1) mild treatment of bronchial asthma 1. Clinical characteristics of intermittent short ① attack breathing, coughing, difficulty in breathing, chest tightness, the weekly attack "two times; ② intermittent period asymptomatic; ③ activities may have a short (half-hour) of the symptoms (wheezing, coughing, dyspnea); ④ nighttime breathing monthly "2; ⑤ only manifestations of chronic allergic cough continued in January above; ⑥ peak expiratory flow (PEF) or 1-second forced expiratory volume (FEV1) "80% of the predicted value. PEF variability rate (PEFR) "20%. 2. Asymptomatic therapeutic purposes, primarily to prevent seizures. Attack, their treatment goal : ① control symptoms; ② maintain normal life activities; ③ avoid nighttime attack; ④ PEFR reduce the rate of change; ⑤ maintain normal lung function; ⑥ reduce or eliminate airway inflammation and lower airway hyper-responsiveness. 3. Treatment measures (1) No asthma or allergy manifested as chronic persistent cough and HPC : 80% of the estimated value of over ① local glucocorticoid daily morning spraying 100 ug (regardless of age), If we can use one (PEF) aerosols, was responding to two (per actuation will be one containing 50 ug); less than 5 years old, storage tank through the fog (spacer) inhalation; greater than 5 years old, can be directly responding to pressure quantitative inhalation (metudoseinhaler, MDI) inhalation. Or a dish of dry powder inhalers, such as the use of Besco Keys (becodisk) Each vesicles containing two Beclomethasone 200ug or 100 ug, with the general pediatric lOOp. G dosage forms, a daily bubble. Inhaled corticosteroid aerosol, water gargle application, in order to avoid fungal stomatitis. ② cell stabilizers, such as using ketotifen (ketotifen, zaditen) each with 0.5 ~ lmg (3 0.5mg with age, with more than three-year-old lmg) medication every 12 hours a meeting. ③ the campaign, contact allergens or other stimuli before inhaled β2-adrenergic receptor agonist, If using salbutamol aerosol (ventolin inhaler), each with a market economy, each responding with salbutamol (O2) lOOug; or a dish of dry powder inhalers (diskhaler), the use of salbutamol if the dish (ventodisk) Each vesicles containing salbutamol 400ug or 200 ug two species, with 200ug general pediatric dosage form. each with a vesicles. ④ disodium cromoglycate an aerosol pressed (each containing disodium cromoglycate owned 3.5 ~ 5 mg), inhalation method Ibid. ① above, which can be ④ two optional one. (2) asthma attack and PEF variability in the rate of more than 20% ① local glucocorticoid, If we can use one aerosol sentence, a daily owned 4 ~ 6 (200 ~ 300ug), a morning meeting inhalation. Less than five years, through inhalation of mist reservoir tank; Greater than 5 years old, can be directly MDI inhalation. Or a dish of dry powder inhalers, such as the use of Besco dish, with 100 ug dosage forms, the daily 2 ~ 3 times, each time a drug bubble that inhaled corticosteroid aerosol, water use mouthwash. ②'s oral or inhaled-adrenergic receptor agonists, such as use of salbutamol aerosol, each one owned. generally every 12 hours responding to a meeting, inhalation method Ibid. Or a dish of dry powder inhalers, such as salbutamol dish, with 200 ug of dosage forms, daily one-two times, each time using a drug foam. According needed every 4 ~ 6 hours to repeat administration of a meeting. For the night attack, the bedside use salbutamol GITS -- all Tening (volmax) 4 mg. ③ theophylline drugs such as breath-taking tea (theovent), the daily 18 ~ 24mg/kg, Each is divided into a 12-hour meeting. ④ cell stabilizers, such as using ketotifen, each with 0.5 ~ lmg (3 years of age with 0.5mg, 3-year-old with lmg above), each of a 12-hour meeting of medication. If the above treatment ineffective, according to moderate asthma treatment. If treatment in a hospital, or by 0.5% salbutamol (ventolin) oxygen or compressed air driven aerosol inhalation. each with 0.5% ~ 0.03ml/kg ventolin 0.01. The greatest amount for each lml with 2 ~ 3 ml saline diluted compressed air or oxygen gas flow "disappear every 4 ~ 6 hours inhaling a meeting. (2) moderate asthma treatment 1. Clinical features ① weekly asthma attack "two times; ② asthma attack lasted for several days; ③ dual need emergency treatment; ④ FEV1 60%, 80%, PEF variability rate of 20%, 30%. 2. Therapeutic purposes ① alleviate symptoms; ② maintain normal lung function best; ③ reduced PEF variability rate changes; ④ maintain normal activities; ⑤ reduce nighttime attack; ⑥ reduce the use of p2-adrenergic receptor agonist frequency; ⑦ reduce acute; ⑧ avoid emergency treatment. 3. Treatment measures (1) glucocorticoid ① local glucocorticoid : If one will be able to use aerosols, 12 daily six-owned (300 ~ 600ug), a morning meeting of application, through inhalation of mist reservoir tank. Or a dish of dry powder inhalers, such as Besco dish with a thin 200 ug dosage form, the morning daily inhaled a three-drug bubble that inhaled corticosteroid aerosol, water use mouthwash. Applications such as systemic glucocorticoids, hormones in the suspension after local application. ② systemic application of glucocorticoid : As inhaled corticosteroid aerosol, at least a week can effectively lower airway responsiveness, ease the symptoms, so if the symptoms persist, but also at the beginning, Application of prednisone a week, a daily dose of 1.5mg/kg ~, or at a dose. After a week gradual reductions, as well as the suspension of oral agents to inhaled corticosteroid aerosol maintain. (2) β2-adrenergic receptor agonist ① inhalation therapy : If using salbutamol aerosol, each responding to a ~ 2 (~ 100 200ug), each of 4 ~ 6 hours inhaling a meeting. Ibid. Inhalation method. Or a dish of dry powder inhalers, such as the use of salbutamol dish, with 200 ug of dosage forms, daily three-four times, each time a drug foam. If treatment in a hospital or by 0.5% ventolin to oxygen or compressed air powered spray inhalation, whenever o. Ventolin 0.01 5% ~ o. 03mi g infants. The greatest amount for each lml with 2 ~ 3mi saline diluted compressed air or oxygen gas flow "disappear, every two-four hours inhaling a meeting. ② For night attack, the bedside use salbutamol sustained-release tablets -- all Tening 4 mg. (3) disodium cromoglycate aerosol inhalation, four times a day, every two to quality, inhalation method Ibid. (4) oral theophylline drugs such as asthma with tea peace, in accordance with the above method of administration. (5) cell stabilizers, such as using ketotifen, each with 0.5 ~ lmg (3 0.5mg with age, with more than three-year-old lmg) medication every 12 hours a meeting. The above options, (1), (3) and (2), (4) 2, in accordance with the illness, can be shared or only choose one. If the above treatment ineffective, can be severe bronchial asthma treatment program to deal with. (3) severe bronchial asthma therapy. Clinical features ① continuing symptoms; ② restricted daily activities; ③ frequency of nocturnal asthma (weekly "2); ④ often need hospitalization or emergency treatment (monthly "2); ⑤ HPC, 60% of the estimated value of the following, PEF variability in the rate of conventional medication, the change rate is still 20% ~ 30%. 2. ① therapeutic purposes to improve lung function; ② close to the normal level of activity; ③ reduced PEF variability rate changes; ④ reduced when a sudden bout of oral corticosteroid dosage; ⑤ reduce nighttime attack; ⑥ reduce the use of p : adrenergic receptor agonist frequency; ⑦ reduce acute; ⑧ reduce hospitalization or emergency number. 3. Treatment measures (1) glucocorticoid ① local glucocorticoid : If one will be able to use aerosols, daily inhalation 8 ~ 16 owned (400 ~ 800ug). Application of a morning meeting. Through inhalation of mist reservoir tank, or a dish of dry powder inhalers. As the Besco dish, with 200 ug of dosage forms, daily from 2 - 4 foam drug, inhaled glucocorticoid aerosol, Application of water gargle. Applications such as systemic glucocorticoids, hormones in the body suspended after the application. ② systemic application of glucocorticoid : at the very beginning, the application of prednisone a week, daily dose of 1.5mg/kg l ~ Good morning, a meeting or taking minutes. After a week gradual reductions, as well as the suspension of oral agents to inhaled corticosteroid aerosol maintain. (2) β2-adrenergic receptor agonist ① inhalation therapy : If using salbutamol aerosol, 4 -6 available daily times, each time responding l ~ 2 (~ 100 200pg), inhalation method Ibid. Or a dish of dry powder inhalers, such as the use of salbutamol dish, with 200 ug dosage forms, the daily 4 ~ 6 times, each time using a drug foam. If treatment in a hospital or by 0.5% ventolin to oxygen or compressed air driven aerosol inhalation. each with 0.5% ~ 0.01 0.03ml/kg ventolin. The greatest amount for each lml with 2 ~ 3 ml saline diluted compressed air or oxygen gas flow "disappear, each a two-hour meeting of an inhaled. ② all Tening daily two times, 12 times an hour, each 4 mg. (3) Aerosol disodium cromoglycate four times a day, every two owned, with the former inhalation method. (4) theophylline sustained-release tablets two times daily, with tea-Surge, in accordance with the above dose of tea a day surge-average volume is divided into three dosing. Application theophylline drugs is the best plasma concentration monitoring, so that the plasma concentration of theophylline 5 ~ 15ug/m1 suitable. (5) membrane stabilizers used as ketotifen, each with 0.5 ~ lmg (3 years of age with 0.5mg, 3-year-old with lmg above), each of a 12-hour meeting of medication.