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    Pediatric Asthma: An Update for Pharmacists

    In this month's peer-reviewed article, learn more about the illness affecting millions.

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    There are several stimuli that trigger asthma exacerbations in children. Severe weather changes and outdoor and indoor environmental exposures to allergens and pollutants are among the major contributors to asthma morbidity in the pediatric population.5-6 According to the American Academy of Allergy, Asthma and Immunology, educating patients and caregivers on minimizing exposure to indoor environmental elements such as dust mites, rodents, cockroaches, pet dander, second-hand smoke, and nitrogen dioxide gas are an important step in delivering individually tailored asthma care. In some cases, these practices have shown similar efficacy and cost in minimizing exacerbations when compared to medications to control asthma.5

    Treatment

    The cornerstones of asthma management are to reduce the impairment associated with asthma and to reduce the risk. Reducing impairment consists of preventing chronic symptoms, decreasing the need for rescue medications, and maintaining normal lung function and optimal activity levels. Reducing risk consists of preventing exacerbations, minimizing emergency care and hospitalizations, preventing loss of lung function, and minimizing adverse effects of therapy.3-5

    The general approach to treatment is based on initial assessment of asthma severity. For patients 12 years and older, the four key components that are assessed to determine treatment include: daytime symptoms, nighttime awakenings, frequency of rescue inhaler use, and activity limitations. Lung function and exacerbation frequency are also considered. Criteria for younger patients are similar, but more specific.3-4 The goals of asthma management in young children are similar to those in older patients: to achieve optimal symptom control, maintain normal activity levels, and minimize the risk of exacerbation, impaired lung development, and medication side effects.3-4

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    Figure 1

     

     

     

     

     

     

     

    Treatment recommendations are presented for three age groups: 0 to 4 years of age, 5 to 11 years of age, and 12 years and older. The differences between groups exist because the course of asthma may change over time, the relevance of different measures of impairment or risk may vary, the potential short and long-term impact of medications may be age-related, and because there are varied levels of evidence available for these age groups. The stepwise approach expands to six steps to simplify actions within each step.3-4 (See Figure 1, click to expand.)

    Portia N. Davis, PharmD
    Assistant Professor of Pharmacy Practice Texas Southern University College of Pharmacy and Health Sciences Clinical Pharmacy Specialist, ...
    Blanca Guerra, PharmD
    Community Pharmacy Resident Texas Southern University College of Pharmacy and Health Sciences
    Abreah Ash
    PharmD. Candidate, 2018 Texas Southern University College of Pharmacy and Health Sciences

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