Asthma: What You Need To Know

Asthma can be a frightening and overwhelming diagnosis. Parents often come in to the office requesting that their child be tested for asthma. How do you know if your child has asthma? Asthma, also referred to as Reactive Airway Disease or RAD, can occur on a mild- intermittent basis or can occur on a persistent basis. Symptoms of RAD may include a chronic cough that has persisted over a month, a chronic cough that only occurs at night, a cough or wheeze that occurs during or after exercise or activity. Sometimes a respiratory illness, such as RSV (Respiratory Syncytial Virus) may predispose or trigger RAD symptoms in a young child. RAD can be hereditary. Children and adolescents with allergies and eczema may be more likely to develop RAD. RAD can have several “triggers”. Common RAD triggers include animal dander, dust mites, molds, pollen, tobacco smoke and second hand smoke, exercise, cold weather, upper respiratory illness. Physical symptoms of RAD include wheezing, feelings of chest tightness and shortness of breath, and a tight, persistent cough. RAD is treated with two types of medications known as Rescue and Controller Medications. Rescue medications are used to bring about fast or immediate relief of the RAD symptoms. These medications open the airway and help to ease the work of breathing. The rescue medication should be available at all times in case of emergent or worsening symptoms. The rescue medications should only be used when RAD symptoms are present.

Controller medications need to be taken on a daily basis to control RAD, whether symptoms are present or not. The controller medications help to prevent RAD symptoms before they start, so the rescue medication might not be needed as often. These medications also help to control the amount of excess mucus and inflammation that occurs as a result of the RAD. If RAD is not adequately treated, scarring and permanent lung restriction can occur. Rescue and controller medications come in inhaler forms, that include metered dose inhalers, flexhalers, and diskus. We recommend that inhalers be administered via a spacer or aerochamber for more accurate administration of the medication. Rescue and controller medications also come in liquid form to be administered through a nebulizer. The nebulizer is the more preferred method for infants and young children and for those children with more acute RAD symptoms. Children and adolescents with RAD should have regular appointments to evaluate the effectiveness of their treatment regimen every 3 to 6 months. An Asthma Action Plan should be established for all children with asthma, and then the plan should be reviewed and updated at subsequent follow up appointments. All children with asthma should have a flu vaccine every season, as well as, all family members.

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