The Hidden Epidemic: Children and Asthma, Part Two

The asthma epidemic continues to spread across America and the industrialized world. Fortunately, a new generation of medications and treatments are relieving symptoms.

Asthma Medications
The most common form of asthma medications are known as bronchodilators, which act to increase airflow among the bronchial airways. The dilators usually come either in an oral dosage or in a pocket-sized inhaler. The American Lung Association believes bronchodilators are probably the only medication children with normal levels of asthma will require. Bronchodilator medications include but are not limited to the beta2-adrenergic receptor agonists albuteraol, sulfate, and levalbuterol. Certain long-acting agonists have been put on the market, but a 2005 Food and Drug Administration health advisory about worsening symptoms have diminished their use somewhat. Albuterol also sometimes results in increased irritability among child users.

For children with mild persistent to severe asthma, the National Heart, Lung, and Blood Institute recommends anti-inflammatory medications such as Cromolyn and Nedocromil. Both have low incidents of side effects and have been safely used for years. They require consistent dosages to be effective, however.

Some long-term asthma medications such as theophylline work for as long as 24 hours, but have been shown to promise potentially serious side effects. Patients' blood levels are usually monitored as a means to managing adverse reactions.

Asthma Attack Prevention
Systemic corticosteroids help to suppress inflammation of the airways by bolstering the body's natural defenses. However, because of the risk of side effects, their use is relegated only to emergencies, when bronchodilators and anti-inflammatories have failed to produce results.

Corticosteroids are naturally-occurring hormones in the human body that effectively help combat allergic reactions as well as many other diseases. They are not performance-enhancing steroids, as the name might suggest. Many asthma sufferers and their parents sometimes administer one dose of corticosteroids every other morning, as a means of preventing severe attacks while minimizing the risk of side effects.

Another class of preventative treatment, glucocorticoids, typically come in inhalers and assist the body in fighting off respiratory inflammation and allergic reaction. Typical glucocorticoids include ciclesonide, beclomethasone, budesonide, flunisolide, and fluticasone.

Some recent innovations in treatment include medications combining steroids with long-acting bronchodilators. In the United States a fluticasone/salmeterol combination is sold through prescription under the name Advair. Another combination, mixing budesonide and formoterol, is prescribed under the name Symbicort.

Markers for Asthma Predisposition
Asthma diagnoses have a hereditary component: the children of asthmatics sometimes develop the disease themselves. Premature children, and children with a low birth weight, are also shown to frequently develop asthma symptoms. Children of mothers who smoked while pregnant, or who have a respiratory infection early in life, are also considered at risk.

Some recent studies show that athletes are possibly more at risk for asthma symptoms than others. Especially among cyclists, mountain bikers, and long distance runners, asthma rates spike considerably when compared to the rest of the population. However, there is no conclusive evidence directly linking training for these sports themselves with asthma diagnosis.

People living in lower income brackets and urban conditions are considered more at risk for asthma diagnoses than those living elsewhere. In particular, urban Black Americans, who are more likely to pursue emergency room visits for symptoms rather than seek outpatient treatment, are three times more likely to die of asthma than compared with whites. Areas with access to better asthma treatment and environmental factor removal are less likely to develop high asthmatic populations than those who do not.

Long Term Prognosis
The true bright side to suffering with asthma is that in most cases the disease is eventually overcome. More than half of all asthmatic children usually lose all effects within a decade. Many adults go on to lead athletic lives without experiencing any symptoms at all.

Finally, perhaps one of the most famous Americans with asthma was President Theodore Roosevelt. Despite debilitating asthma through much of his childhood, a rigorous exercise program overseen by his father resulted in a robust health by the time the future statesman entered college. Roosevelt later became one of the most famous outdoorsmen in history, and was responsible for introducing the benefits of exercise to tens of millions worldwide.

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