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What different asthma medications are available?
Once diagnosed with asthma, your child will probably be prescribed specific medication. Just as there are two main problems associated with asthma: bronchoconstriction and inflammation - there are two main types of asthma medications: bronchodilators and anti-inflammatories.


Bronchodilators

Bronchodilators usually come in the form of inhalers, or in liquid form for young children. (Check out the section on asthma medication delivery devices) Bronchodilators provide relief by easing bronchial muscle tension and constriction. Tradenames of commonly used bronchodilators include Ventolin, Alupent and Bricanyl. Consult your health care professional for more details.

Bronchodilators should only be given as needed, for example during a cold, or for shortness of breath, or wheezing. Children with mild asthma symptoms can often be treated adequately with the occasional use of bronchodilators alone. The need for bronchodilators can act as a gauge of asthma control. Depending on the child's particular condition, needing bronchodilator medication more than 3 or 4 times per week usually indicates the presence of inflammation and inadequate asthma control. At least 25% of asthmatic children have symptoms mainly due to inflammation. These children should also take anti-inflammatory medications.


Anti-inflammatory medications

Non-Steroidal

One category of anti-inflammatory medications are the non-steroids which although are still available, are used less frequently than inhaled steroids(see below). These include sodium cromoglycate, know as Intal, and nedocromil sodium, known as Tilade, which are inhaled - and ketotifen, known as Zaditen, which is swallowed. Non-steroid anti-inflammatories can take longer to take effect - up to 8 to 10 weeks - and have few side-effects. In general, children with mild but frequent symptoms, may benefit from non-steroidal anti-inflammatory medication.

Corticosteroids

Another category of anti-inflammatory medication includes corticosteroids. Examples of corticosteroids given to children include: Prednisone and Predilisone(Pediapred), both which are swallowed. Orally-administered steroids are effective helping children with acute asthma. However, prolonged or daily use can result in negative side-effects such as growth delay.

Inhaled steroids such as fluticosone known as Flovent and budesonide, known as Pulmicort, are effective treating children with chronic asthma and are considered very safe. Indeed inhaled steroids are considered much safer than orally-administered steroids. In general, the goal of steroid treatment is to achieve as few symptoms as possible with the lowest possible dose. Recent studies have confirmed that inhaled steroids are safe in children and do not interfere with growth.

Anti-Leukotrienes



Thanks to today's better understanding of asthma, scientists have been able to develop medications that specifically target inflammation at the molecular level. Leukotrienes, substances made during inflammation, are thought to contribute to the development of asthma symptoms. Zafirlukast(Accolate) and Montelukast(Singulair) are medications which block leukotrienes (Anti-Leukotrienes). As they have recently become available, there is not much experience with these in children. Anti-Leukotrienes are taken by mouth (therefore easy to take, without worrying about inhaler device technique) and are not corticosteroids. Whether or not an asthmatic is prescribed these medications depends entirely on the child's age and specific situation.


Medication use

For immediate or acute relief of asthma symptoms, bronchodilators are the best option. In time, as airway inflammation is decreased by preventative, anti-inflammatory medications, the occurrence of acute attacks will be reduced, as will the need for bronchodilators. However, regular use of anti-inflammatory medications may still be required on an on-going, maintenance basis.

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