![]() Children age 6 and older may benefit from the addition of this therapy to their current treatment plan. Nucala, an injectable medication, is given to children every four weeks to help control severe asthma. Theophylline (Theo-24, Elixophyllin) is not used as often now as in past years. This is a daily medication that opens the airways (bronchodilator). This reduces the risk of a severe asthma attack. LABA medications should only be given to children when they are combined with a corticosteroid in a combination inhaler. In some situations, long-acting beta agonists have been linked to severe asthma attacks. They include the combinations fluticasone-salmeterol (Advair HFA), budesonide-formoterol (Symbicort), fluticasone-vilanterol (Breo, Ellipta) and mometasone-formoterol (Dulera). These medications contain an inhaled corticosteroid plus a long-acting beta agonist (LABA). Seek medical advice right away if your child has any unusual psychological reaction.Ĭombination inhalers. In rare cases, montelukast and zileuton have been linked to psychological reactions such as agitation, aggression, hallucinations, depression and suicidal thinking. They can be used alone or as an addition to treatment with inhaled corticosteroids. These include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo). These anti-inflammatory drugs include fluticasone (Flovent HFA), budesonide (Pulmicort Flexhaler), beclomethasone (Qvar RediHaler), ciclesonide (Alvesco, Omnaris) and mometasone (Asmanex HFA). These are the most common long-term control medications for asthma. Types of long-term control medications include: These medications may be used seasonally if your child's asthma symptoms become worse during certain times of the year. Known as maintenance medications, these are generally taken every day on a long-term basis to control persistent asthma. This is known as the stepwise approach to asthma treatment. If your child's asthma is well controlled, the doctor may "step down" treatment by reducing your child's medications. The definition, epidemiology, potential mechanisms and management of nocturnal asthma are discussed in this review.Based on your record of how well your child's current medications seem to control signs and symptoms, your child's doctor may "step up" treatment to a higher dose or add another type of medication. Available therapy includes inhaled and oral corticosteroids, sustained-release theophylline, long-acting b-agonists, leukotriene- modifying agents and anticholinergic medication. Selective timing of medication can increase its efficacy and reduce its toxicity. While sleep appears to play a role in the pathophysiology of nocturnal asthma, it is not essential to it. In addition, underlying differences in the glucocorticoid receptor and b- receptors in these patients may diminish their ability to respond to therapy. Patients with nocturnal asthma symptoms may have greater nighttime activation of inflammatory cells and mediators, lower levels of epinephrine and increased vagal tone. The mechanisms of nocturnal asthma are intimately related to circadian rhythms, which influence inflammatory cells and mediators, hormone levels and cholinergic tone. and is believed to be quite common, affecting a majority of asthmatics. Nighttime worsening of asthma has been recognized since the 5th century A.D. Nocturnal asthma, defined as an exacerbation of asthma at night, is associated with increases in symptoms and need for medication, increased airway responsiveness and worsening of lung function.
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