Take a Deep Breath Asthma in Children

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Take a Deep BreathAsthma in Children

• Michael W. Peterson, M.D.
• Professor and Chief of Medicine
• UCSF Fresno

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Why should we talk about asthma?

• The most common chronic disease in children
• The most common cause for children missing school
• One in six Fresno children have asthma!
• Asthma is increasing in the developed world
• Asthma deaths are increasing

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What is asthma?
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The Lung Airways
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What Happens to the Airways in Asthma?
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What happens to the Airways in Asthma?
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What happens during an asthma attack?
Animation
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What does it feel like to have this happen?
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What causes asthma?
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What causes asthma?

• ?
• Genetics/ Inheritance
• Living in a house with parents who smoke
• Frequent and recurrent viral URI
• Abnormal immune responses to environmental agents
  (allergy)
• Unhealthy air (air pollution)

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How do I know if I have asthma?

• Coughing
• Shortness of breath
• Waking up at night (with a cough)
• Coughing after exercise or cold air exposure
• Wheezing (example)
• Breathing tests (spirometry and peak flow)

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Managing Asthma

• Prevention Recognizing and Avoiding triggers (1
  ounce of prevention 1 pound of cure?)
• Treating asthma
• Controllers
• Relievers

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Preventing
Dust mites live on human skin debris in carpets,
pillows, Clothes, bedding
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Managing Dust Mite Exposure

• Minimize carpets (hardwood floors)
• Wash bedding with hot water
• Dry cleaning or washing clothing
• Use of barriers
• Low humidity

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Preventing
Cockroaches most important in urban
environments. Management with cleanliness,
keeping food containers sealed, etc.
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Prevention

• Avoiding situations known to exacerbate the
  asthma (strong odors, smoke, etc.)
• Pretreating where you anticipate exacerbations
  (cold air, exercise)

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Treating Asthma

• Controllers Asthma is an inflammatory disease
• Anti-inflammatory medication inhaled steroids
  and oral steroids
• Use in any patient with symptoms that occur more
  often than twice a week, if any night-time
  symptoms more often than twice per month or if
  abnormal lung function
• Leukotriene inhibitors (Singulair or Accolate)

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Treating Asthma

• Controllers/ Relievers
• Long acting beta agonist inhalers (Serevent)
• Relievers should only be used for short-term
  symptom relief. Heavy use signals TROUBLE
• Short-acting beta agonists (albuterol)
• Anticholinergic medications (Atrovent)

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Treating Asthma

• Asthma is a chronic disease like diabetes
• Patients need to understand their own disease
• Every patient should have an action plan What to
  do in the event of problems-when to call the
  doctor, when to increase medications

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Asthma

• Asthma is a chronic disease that can be managed
  and controlled
• The goal should be NORMAL ACTIVITY