Management of asthma in Children

The prevalence of asthma in children has increased 160 percent since 1980, and the disease currently affects nearly 5 million children in the United S tates. The National Asthma Education and Prevention Program provides guidel ines for improved asthma care. The goals of this program are to limit the f requency, severity and costliness of asthma exacerbations through extensive education of physicians, children and caregivers. The four components of a sthma management include regular assessment and monitoring, control of fact ors that contribute to or aggravate symptoms, pharmacologic therapy and edu cation of children and their caregivers. The guidelines recommend a stepwis e approach to pharmacologic treatment, starting with aggressive therapy to achieve control and followed by a "step down" to the minimal therapy that w ill maintain control. Quick relief of symptoms can be achieved preferential ly by the use of short-acting beta, agonists. Medications for long-term con trol should be considered for use in children with persistent symptoms. Inh aled corticosteroids are the most potent long-term anti-inflammatory medica tions. Other options include long-acting beta, agonists, cromolyn sodium an d nedocromil, antileukotriene agents and theophylline. All have advantages and disadvantages in individual situations.