When wheezing and coughing prevail

Once a child is about 3 years old, confirming a diagnosis of asthma gets easier. Some children with asthma have restless nights interrupted with fits of coughing, even when they haven’t got a chest infection or cold – this is a symptom to watch for. It is helpful to note the things that you know aggravate your child’s asthma, as well as noting if there is an improvement when asthma drugs are used. After the age of 3, the medication is more effective because the child’s breathing tubes are bigger and respond better to treatment.

When your child is able to blow air consistently (normally around the age of 6) your doctor or asthma nurse will be able to measure the airflow in their breathing tubes, using a peak flow meter. This is a tube device with a gauge on the side. Taking a deep breath and then forcing the air out through the tube will give a reading, that can be compared with pre-defined measurements, related to age and sex. It is a useful aid to diagnosing asthma.

Treating Asthma

The drugs used to treat Asthma can be divided into several groups:

Reliever medications (such as salbutamol or terbutaline) are usually in blue coloured inhalers, which helps to identify them easily. They work by relaxing the muscular coating of the breathing tubes, allowing the air to get in and out more easily. The tightness in the airways can be painful – it’s rather like getting a cramp in a calf, which explains, very simply, why chest tightness due to asthma can be painful.

These short acting relievers start to work within a few minutes and the effects last for up to 4 hours. They are used in bigger doses if there is an asthma attack.

Long acting relievers are given twice a day by an inhaler. They are added when regular preventer treatment fails to control the asthma.

Preventers (such as beclometasone, terbutaline or fluticasone) are packaged in inhalers, which are coloured in shades of brown, or orange (fluticasone). They are steroid medicines which work on the soreness and swelling (inflammation) in the breathing tubes, reducing mucus. They stop the twitchiness (irritability) in the airways, but must be taken on a regular basis to control the asthma and prevent it getting worse.

Leukotriene receptor antagonists (LTRA). This is a tablet form of asthma medication which has been available in the UK for over a year. There are two medicines – montelukast and zafirlukast. They are only used as additional treatment to reliever and preventer medication at the moment, and only for children from 6 (montelukast) or 12 years (zafirlukast) of age. LTRAs work on only one chain of the very complex inflammatory processes within the lungs.