Help with childs asthma?

Question:

My son is 4, and has asthma. He was diagnosed right around his 2nd birthday. He takes pulmicort once a day, and has an albuterol inhaler/spacer, and also the albuterol for his nebulizer. In the fall it gets very very bad. Last fall he was hospitalized 3 times, and one of those times was actually taken by ambulance to trauma because it was so bad. They have changed his medicines around many times, and this seems to be working decently well, but he still has an "attack" about twice a week. It isnt related to exercise. No one smokes, no pets, clean house, etc. Problem is, its comin back to fall, and i am so nervous it is going to get really bad again. I am looking for any other tips to help him, other than the common stuff. I dont want to keep him inside all fall, but i dont want to go through what we went through last yr either. Thanks!

Answers:
You should attempt to find out what your sons "triggers" are..i am a resp. therapist at Childrens Hospital of Philadelphia and my biggest thing i try to discuss with families is the triggers.once you figure that out you can attempt to avoid it, or live with it in a better way. Such as dust mites, cochroaches, chemical irritants, ect...even if you dont THINK you have them in your house you still may. Try to keep a log of what your son was doing (activities, foods, meds, weather, ect...)previous to his flare ups and see if there is anything that seems to the key connection in them all. Does you son have allergies too? If he has not been tested yet check that, maybe he needs allergy shots or meds he takes everyday. Also talk to your doctor about maybe upping the dose of your childs pulmicort, he should be getting 0.5mg twice a day, like 8am and 8pm. If your son continues to have issues try to find a doctor that is an asthma/allergy specialist.

Good luck, i wish you all the best and an asthma free year!

Albuterol might not be strong enough to overcome his asthma attacks. Xopenex (Levelbuterol HCL) is stronger than Albuterol and is often used in patients with heart problems or bad asthma. It is available as unit doses for nebulizer and inhaler. Xopenex has a nice bonus in that it is a mast cell stabilizer too (prevents the release of mediators of inflamation).

Because some drugs are not tested on children, like Atrovent, they are not used. Atrovent is a bronchodilator that acts on a different site in the lungs than Albuterol or Xopenex. It can be prescribed off-label (for drugs not specifically tested on children) and used in nebulizers and inhalers.

Pulmicort can be given twice a day. It's the only inhaled steroid commonly used with children.

There are other options like Singulair, that block the mediators of inflammation that cause the asthma attacks.

I would talk to the doctor about changing his Albuterol to Xopenex. Also, you might want to ask if Pulmicort can be given twice a day. That's a good place to start. You would then have stronger medication controlling the asthma and stopping it, if it happens. If he still needs more asthma control, Atrovent might be a good addition to his drug regime.

Help with childs asthma?

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