All You Need to Know About Your Kid’s Asthma
A convenient way to get asthma medicines down to a child’s lungs is the use of asthma inhalers. Many parents and kids do not like using nebulizers because an asthma treatment with them takes long.
Asthma Inhalers for children
However, being convenient, asthma inhalers should be used properly to be effective, observing special rules of use. To simplify the way of use, a metered-dose inhaler can be combined with a spacer or even a spacer with a mask, but still, in this case, your kid should use the device correctly. A spacer for inhalers is a small device that is attached to an inhaler and sometimes includes a mask. They have a holding chamber that keeps the drug in the spacer until your kid gets a breath so that he (she) does not need to coordinate getting a breath with activating the inhaler.
In pediatric practice, Ventolin and Pulmicort are often prescribed for inhalations but not simultaneously, in a certain sequence. Pulmicort is a strong locally-acting hormonal drug. It is prescribed as a part of complex therapy when the therapeutic effect of Ventolin does not occur in the case of advanced forms of bronchial asthma. The inhalation hormone is safe for children of all ages. Therefore, it is prescribed for young infants.
Rules of inhalation in a child:
• Inhalation in children with bronchial obstruction is carried out sitting or with a raised back (in reclining posture).
• The duration of the procedure depends on the diagnosis, on average it takes 10 minutes.
• Breathing during inhalation should be in the ordinary course. Deep breathing can provoke a suffocating cough.
• After the procedure, the child should be provided with physical rest.
• In the autumn-winter period, after treatment, a child should not go out for an hour.
Ventolin inhalers for children: instructions for indications and contraindications
Many pediatricians actively prescribe the drug Ventolin to children with the following conditions and diseases:
• Cough of different origin;
• Bronchitis (mostly obstructive);
• Acute attack of bronchial asthma;
Ventolin inhalers are used not only to treat the underlying disease of the respiratory system but also for its prevention as well as prevention of seizures in the case of bronchial asthma. Also, Ventolin effectively helps cope with bronchial asthma, which does not respond to therapy with other bronchodilator drugs.
Ventolin should not be used by children with increased sensitivity to the components of the drug. It is not recommended to use Ventolin in the tablet form for children under 6 years. The age of the child under 2 years is also a contraindication for the use of Ventolin.
Types of Asthma Inhalers
There are two types of asthma inhalers, including the older metered-dose inhaler (MDI) and the newer dry powdered inhaler (DPI). Many people think that the DPI is easier to use because it is breath-actuated, while the MDI requires getting a deep breath with activating the inhaler.
- MDIs (HFA) – CFC-free hydro fluoroalkene propellant inhalers
- MDIs (CFC) – inhalers with chlorofluorocarbons, they have been laid off due to environmental reasons
- DPIs – typically used in children older than 5 years because younger kids usually blow into it, instead of breathing in.
- Breath-actuated MDIs (HFA) – they are more expensive than other MDIs
When using a DPI, many kids make the following mistakes:
- forgetting to breathe out fully before using the inhaler
- positioning the device incorrectly
- not getting a deep, forceful inhalation
- not breathing out slowly afterward
- not holding their breath for about 10 seconds
The same mistakes are sometimes common for metered-dose inhalers. A common mistake is to forget to get a slow, deep inhalation.
Rescue asthma inhalers
Short-acting beta-agonists with the quick-relief effect on asthma symptoms are used in the rescue asthma inhalers:
- Proventil HFA
- Ventolin HFA
- Ventolin HFA 60
- ProAir HFA
- ProAir RespicClick (powder)
- Xopenex HFA
All of these inhalers include the use of Albuterol except for Xopenex HFA, which is designed for the use of Levalbuterol.
These types of inhalers are only used in case of acute need and not every day. Consult your pediatrician if you believe your child seems to need the quick-relief asthma medication more than 2 times a week.
Unlike rescue inhalers, which can give a quick-relief effect on asthma symptoms, steroid inhalers are designed for a use on a daily basis to help prevent your kid from advancing asthma symptoms.
- Flovent HFA (fluticasone) – MDI for kids who are not older than 4 years
- Flovent Diskus (fluticasone) – DPI for kids who are not older than 4 years
- Qvar (beclomethasone) – MDI for kids who are not older than 5 years
- Aerobid (flunisolide) – MDI for kids who are not older than 6 years
- Pulmicort Flexhaler (budesonide) – DPI for kids who are not older than 6 years
- Asmanex Twisthaler (mometasone) – DPI for children who are not older than 12 years
- Alvesco (ciclesonide) – MDI for children who are not older than 12 years
All these inhalers are available in multiple strengths to allow getting your kid’s asthma under good control. If you see that a low dose inhaler does not help your kid, then it is recommended to move up to the higher dose (from Qvar 40 to Qvar 80).
For kids with moderate to severe asthma who do not cope with an inhaled steroid, an inhaler combining a steroid with a long-acting beta-agonist can be very helpful.
- Advair Diskus – DPI for kids who are not older than 4 years
- Advair HFA – (Flovent + Serevent) – MDI for kids who are not older than 4 years
- Symbicort – (Pulmicort + Foradil) – MDI for kids who are not older than 12 years
- Dulera – (Asmanex + Foradil) – MDI for kids who are not older than 12 years
How to use an inhaler in children correctly
- Before using the inhaler, it is necessary to remove the cap, lightly pressing it on the side.
- Shake the inhaler so that its contents are evenly mixed.
- Take the inhaler vertically so that it is grasped with all fingers of the hand (with the thumb to be located below the mouthpiece).
- Your kid should take a deep breath.
- Then your kid must take the mouthpiece in the mouth between the teeth and press it with the lips.
- Simultaneously, by getting a slow and steady breath, press the top of the inhaler and inject the drug. One click corresponds to the spraying of one dose of the drug (100 μg of Albuterol).
- Hold the breath and pull the inhaler out of the mouth.
- The kid should continue to hold his breath as far as possible.
- If your kid needs another inhalation, then it should be done 30 seconds after the first, repeating the above items.
- Close the inhaler with the cap.