Asset Details
Do you wish to reserve the book?
Management of severe asthma in children
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Management of severe asthma in children
Do you wish to request the book?
Management of severe asthma in children
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Management of severe asthma in children
2010
Overview
Children who are referred to specialist care with asthma that does not respond to treatment (problematic severe asthma) are a heterogeneous group, with substantial morbidity. The evidence base for management is sparse, and is mostly based on data from studies in children with mild and moderate asthma and on extrapolation of data from studies in adults with severe asthma. In many children with severe asthma, the diagnosis is wrong or adherence to treatment is poor. The first step is a detailed diagnostic assessment to exclude an alternative diagnosis (“not asthma at all”), followed by a multidisciplinary approach to exclude comorbidities (“asthma plus”) and to assess whether the child has difficult asthma (improves when the basic management needs, such as adherence and inhaler technique, are corrected) or true, therapy-resistant asthma (still symptomatic even when the basic management needs are resolved). In particular, environmental causes of secondary steroid resistance should be identified. An individualised treatment plan should be devised depending on the clinical and pathophysiological characterisation. Licensed therapeutic approaches include high-dose inhaled steroids, the Symbicort maintenance and reliever (SMART) regimen (with budesonide and formoterol fumarate), and anti-IgE therapy. Unlicensed treatments include methotrexate, azathioprine, ciclosporin, and subcutaneous terbutaline infusions. Paediatric data are needed on cytokine-specific monoclonal antibody therapies and bronchial thermoplasty. However, despite the interest in innovative approaches, getting the basics right in children with apparently severe asthma will remain the foundation of management for the foreseeable future.
Publisher
Elsevier Ltd,Elsevier,Elsevier Limited
Subject
/ Adrenal Cortex Hormones - therapeutic use
/ Anti-Asthmatic Agents - administration & dosage
/ Anti-Asthmatic Agents - therapeutic use
/ Asthma
/ Azathioprine - therapeutic use
/ Biological and medical sciences
/ Bronchodilator Agents - administration & dosage
/ Bronchodilator Agents - therapeutic use
/ Budesonide - therapeutic use
/ Budesonide, Formoterol Fumarate Drug Combination
/ Child
/ Cyclosporine - therapeutic use
/ Ethanolamines - therapeutic use
/ Humans
/ Interdisciplinary Communication
/ Methotrexate - therapeutic use
/ Steroids
/ Terbutaline - therapeutic use
