Asthma: Special Patient Population

Asthma: Special Patient Population :

 Children under the age of 5 years

Asthma is difficult to diagnose in children younger than 5 years. Because children's airways are smaller, wheezing can be confused between asthma and an upper respiratory infection.

To add to the confusion, fast-acting medications such as Beta2 Agonists can relieve wheezing in children with or without asthma.

Your primary care doctor may choose to treat you with long-term medication, such as inhaled corticosteroids, after weighing the risks against the benefits of the medication. They will do this, especially if the asthma is older than 6 years.

Inhaled corticosteroids are the drugs of choice for children, Montelukast and Cromolyn. Treatment is usually prescribed for a trial period of 4-6 weeks and then stopped if no benefit is seen.

Side effects of inhaled corticosteroids in very young children include growth retardation at any age. But uncontrolled asthma also slows down a child's growth rate. So, your primary care physician will discuss the risks and benefits of starting inhaled corticosteroids before starting the medication.

Elderly patients

Polypharmacy in elderly patients complicates treatment in this group. used medications such as beta blockers for hypertension, aspirin and other NSAIDs analgesia are contraindicated in the treatment of asthma.

All elderly patients are advised to inform their doctor about all medications they are currently taking.

Side effects of long-term use of high-dose corticosteroids for the treatment of asthma include the development of osteoporosis and diabetes. Discuss management strategies with your primary care physician before starting this medication.

Pregnant women

Pregnancy is complicated by asthma because the fetus needs oxygen supply above and beyond what the mother needs. Asthma also increases the risk of other pregnancy complications, eclampsia, preterm birth, and low birth weight.

It is more beneficial to take asthma medicine during pregnancy than to be exposed to asthma. If you are pregnant or planning to become pregnant, discuss your asthma action plan with your doctor. Regardless of how you control your asthma, it is important to watch and control your asthma during pregnancy.

Children and toddlers

Physical activity can trigger asthma.

There are several medications that can help prevent asthma during exercise. These include:

Short-acting beta2 agonists These are often inhaled before physical activity and have a duration of action of up to 2,3 hours.

Long acting Beta2 agonists, These are inhaled and have a duration of action of up to 12 hours. Yet, tolerance to this drug can develop, and with prolonged use, the duration of the drug's action decreases.

Leukotrienes This is often taken a few hours before physical activity and can help asthma symptoms.

It is important to ease into training and not exert yourself . A simple pre exercise warm up, proper clothing, and post exercise warm-up will help fight asthma.

With proper control, asthma sufferers can take part in physical activity or sports as desired

Surgical patients

Asthma is a significant risk factor for general morbidity. For example, tracheal intubation can trigger an asthma attack.

Patients are advised to notify the surgical and anesthesia team before surgery to expect complications.

In the next and final part of this series, we discuss treatment options and how to control asthma.