Bronchial asthma is the most common chronic disease in children and adolescents. In Europe, around 10 percent of all children under the age of 15 are affected. In at least 70 percent of cases, the disease breaks out before the age of 5. However, bronchial asthma in children is often overlooked or treated too late.
Bronchial Asthma Medication
Bronchial asthma is not yet curable, but numerous medicinal and other therapeutic aids are available. The aim of every therapy is to enable the sick child to fully participate in normal life. Age-appropriate asthma training courses have proven effective for this. Children, adolescents and their parents receive important information about illness and therapy. The family will be involved in learning to recognize symptoms and how to deal with the disease safely.
There are basically two groups of asthma medication:
- Bronchodilator relievers are used primarily as a quick reliever medication for acute complaints. (Reliever therapy)
- Anti-inflammatory controllers must be taken for a long time and achieve a long-term effect. (Long-term therapy)
Reliever to widen the airways
Reliever (derived from the English to relieve = to make things easier) should be taken when needed. They help with acute complaints and, thanks to their bronchodilator effect, relieve asthma symptoms in the short term . Most of them are short-acting beta-2 sympathomimetics (SABA) for inhalation. For example:
- Salbutamol or
These remedies, also known as bronchodilators, relax the cramped bronchial muscles within a few minutes and thus lead to an expansion of the airways.
On-demand medication is very effective in relieving acute asthma symptoms , but has no effect on the inflammation that underlies asthma. This also applies to the long-acting beta-2 sympathomimetics (LABA), which are used in an advanced stage of the disease. However, these should only be used in combination with an anti-inflammatory inhaled cortisone preparation (ICS) . In this context, one speaks of so-called combination preparations.
Controller against inflammation
There are various inhalation devices that transport the active ingredient into the bronchi. Controllers are anti-inflammatory and dampen the constant inflammation of the airways. These active ingredients make attacks and asthma symptoms less frequent and less severe. In order to achieve this effect, however, these asthma medications must be used regularly and continuously. One speaks therefore of long-term medication.
Inhaled corticosteroids (ICS) – also known as cortisone in common parlance – are the most effective controllers based on current knowledge. In adults, they should form the basis of long-term asthma therapy because they treat the inflammatory processes in the airways that underlie asthma.
The cortisone preparations are taken as an asthma spray. By inhaling the cortisone directly enters the respiratory system and can work there effectively. This significantly reduces side effects. Modern ICS preparations allow good asthma control even with a very low dose . During regular check-ups with the attending physician, the medication dose should be checked again and again and set to the lowest effective dose.
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In the case of severe asthma, cortisone can also be given briefly in the form of tablets. Since cortisone tablets act on the whole body, however, they can cause more severe side effects than the cortisone spray. According to the recommendations of the current National Asthma Care Guideline, cortisone should therefore only be prescribed as a tablet if treatment with antibodies does not improve the asthma.
Unfortunately, to this day there is no way to cure asthma . The chronic respiratory disease is usually well treatable with medication. The aim of every asthma therapy is that patients are largely symptom-free and physically fit. In most cases, this can also be achieved through an individually tailored treatment.
How is Asthma Treated?
Asthma treatment consists on the one hand of drug therapy with anti-inflammatory and bronchodilator drugs. The aim is to improve chronic inflammation and the narrowing of the airways. The therapy is based on the asthma control and is structured as a so-called step scheme . For adults as well as for children and adolescents there is a separate level scheme with five or six therapy levels.
The treatment is intensified from step to step. The attending physicians individually select the level for each person at which good asthma control can be achieved, but at the same time causes as few side effects as possible. The National Care Guideline recommends: If several treatment options are available, the one with fewer side effects should always be chosen, even if it is the more expensive one.
In addition to the asthma medication, non-drug measures are also recommended for the treatment of asthma. These are, for example, asthma training courses in which patients learn to better assess their symptoms. Non-drug treatment also includes:
- physical training ,
- Weight loss,
- Smoking cessation and
- various breathing techniques
It’s important to note that frequent comorbidities such as chronic runny nose (rhinitis) or sinusitis (sinusitis) should be treated appropriately.
In the case of mixed or allergic asthma , specific immunotherapy (SIT) with allergens is also a possible therapy option.
The treatment of asthma in children is similar to that in adults, but there are also some differences and peculiarities.