Advances in Pediatric Asthma Treatments, Research Paper Example

Abstract

Pediatric Asthma continues to be a critical issue for many young children across many different population groups. Asthma occurs more in the pediatric population than in any other age group, and approximately five million children under the age of 18 have been treated for this condition in the United States alone. Therapeutic advances have been instrumental in improving these circumstances for many children. The treatment options that are available for asthma patients, such as bronchodilators in the form of Short-Acting B2Agonists and Long-Acting B2Agonists, inhaled corticosteroids, and Montelukast must be explored in order to better understand the nature of pediatric asthma and the potential for improved management and recovery across different population groups (van Aalderen, 2012).

Introduction

In recent years, pediatric asthma has increased in scope and prevalence, particularly in the African American population, in spite of advanced treatment methods. Holgate (2011) supported the belief that new approaches to the discovery of new asthma-based drug therapies are essential, along with an improved understanding of asthma stratification. Furthermore, Busse (2011) addressed the importance of expanding clinical data and information in order to achieve desirable treatment outcomes. From a pharmacological perspective, it is necessary to utilize existing treatment methods in the appropriate manner and to also consider their efficacy for patients over the long term. The following discussion will address pharmacological options for pediatric patients with asthma and will consider how these alternatives improve breathing and asthma-related events on a short and long-term basis.

Short-Acting B2Agonists

Short-Acting B2Agonists serve as a short-term solution to assist in the reduction of wheezing in a bronchodilation capacity, particularly in older children (van Aalderen, 2012). However, their effectiveness in younger children is less known, so for this group, other alternatives should be explored in order to achieve the desired results (van Aalderen, 2012). In some patients, these drugs are prescribed on an as-needed basis, while others are prescribed this method on a more regular basis (van Aalderen, 2012).

Long-Acting B2Agonists

Long-Acting B2Agonists are typically used for patients over the age of five, but are used more widely in older children (van Aalderen, 2012). Nonetheless, this option is most effective in the adult population (van Aalderen, 2012). Therefore, it is recommended by the FDA that this treatment alternative should not be used independently but in conjunction with inhaled corticosteroids (van Aalderen, 2012). The risk of asthma-related hospitalization and other side effects is much greater when this treatment is used on its own (van Aalderen, 2012). However, the use of this therapy in children and adults on a long-term basis is not encouraged because there is an increased risk of mortality (Schultz and Martin, 2013).

Inhaled Corticosteroids

Inhaled corticosteroids are perhaps the most recognizable treatment method and are most effective when used in higher doses, particularly for wheezing as related to colds (van Aalderen, 2012). This type of treatment is most effective for older children and provides significant support in managing asthma and related symptoms (van Aalderen, 2012). In some patients, however, there are considerable disadvantages to this treatment, particularly as it may not be effective in preventing the reduction of lung functionality over time (Bush and Saglani, 2010). In a large number of cases, this type of therapeutic intervention provides the most widespread benefit to patients in the form of symptom alleviation and the restoration of a greater quality of life (Farber, 2010). However, this approach is not without its risks, and therefore, caution must be exercised when addressing the most important issues associated with this type of treatment over the long term (Farber, 2010).

Montelukast

Montelukast is known as a leukotriene receptor agonist that has been deemed safe and effective for children over the age of five months (van Aalderen, 2012). This treatment is typically prescribed in chewable tablet form, in either 4 or 5mg doses (van Aalderen, 2012). This treatment reduces wheezing in children and may be a positive improvement over the use of inhaled corticosteroids (van Aalderen, 2012). This form of therapy is perhaps most favorable in pediatric patients who suffer from milder forms of asthma and who do not respond well to the use of inhalers (Wu et.al, 2009).

Other Options

Some patients do not respond particularly well to standard treatment methods; therefore, they must be provided with other alternatives to achieve positive treatment outcomes (Bush and Saglari, 2010). In cases where asthma symptoms are severe and persistent, possible options include inhaled corticosteroids at higher doses than normally prescribed, epinephrine in injectable form in some patients, and omalizumab in cases where appropriate, along with steroid-sparing pharmacologics such as methotrexate or ciclosporin (Bush and Saglari, 2010). In the case of omalizumab, this type of therapy is not recommended for young children under the age of 12; therefore, extreme caution must be exercised when using this drug to treat asthma-related symptoms in older children (Townley et.al, 2010). Cromones are used in patients with more severe forms of asthma up to four times daily, while theophylline, an anti-inflammatory bronchodilator agent, is effective in some cases but has greater side effects than some other alternatives (Schultz and Martin, 2013). In addition, it is known that in some cases, a combination of therapies is essential because these options provide the greatest possible opportunity to manage the asthmatic condition without serious complications (Farber, 2010).

Conclusion

A variety of pharmacological methods are available for the treatment of pediatric asthma. It is important to identify the severity of the condition, the age of the patient, and other risk factors as required to ensure that the appropriate method and dosage are chosen. It is important for clinicians to properly diagnose asthma in children and to determine its severity in order to make effective decisions regarding the appropriate treatment methods for consideration. In some cases, a single form of pharmacotherapy is sufficient, while others may require a combination of treatments in order to alleviate symptoms and to improve overall lung function. Careful analysis and examination of all patients is necessary in order to provide children suffering from asthma with the best possible quality of life, considering the limitations of this condition and its overall impact on their lives.

References

Bush, A., and Saglari, S. (2010). Management of severe asthma in children. Lancet, 376(9743), 814-825.

Busse, W. (2011). Asthma diagnosis and treatment: filling in the information gaps. Clinical Immunology, 740-750.

Farber, H.J. (2010). Optimizing maintenance therapy in pediatric asthma. Current Opinion in Pulmonary Medicine, 16(1), 25-30.

Holgate, S. (2011). Pathophysiology of asthma: what has our current understanding taught us about new therapeutic approaches. J.Allrgy: Clinical immunology, Vol 128, 495-505.

Schultz., A., and Martin, A.C. (2013). Outpatient management of asthma in children. Clinical Medical Insights in Pediatrics, 7, 13-24.

Townley, R.G., Agrawal, S., and Sapkota, K. (2010). Omalizumab for pediatric asthma. Expert Opinion on Biological Therapy, 10(11), 1595-1608.

Van Aalderen, W. (2012). Childhood asthma: diagnosis and treatment. Scientifica, 2012, retrieved from http://www.hindawi.com/journals/scientifica/2012/674204/

Wu, W.F., Wu, J.R., Dai, Z.K., Tsai, C.W., Tsai, T.C., Chen, C.C., and Yang, C.Y. (2009). Montelukast as monotherapy in children with mild persistent asthma. Asian Pacific Journal of Allergy and Immunology, 27, 173-180.