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Asthma Part 3: Special Patient Populations

Children Below 5 Years of Age

Asthma is difficult to diagnose in children below 5 years of age. As the airways of children are naturally small, wheezing, when audible, can be confused between asthma and simple upper respiratory tract infections.

To add to the confusion, fast acting medications like Beta2 Agonists will relieve wheezing in children irrespective of whether they have asthma or not.

Your primary physician might elect to treat your child with long term medications like inhaled corticosteroids after weighing the risks vs the benefits of the drug. They will do so especially if the asthma proceeds beyond 6 years of age.

Inhaled corticosteroids are the preferred drug of choice for young children, Montelukast and Cromolyn being the other options available. Treatment is usually prescribed over a trial period between 4-6 weeks and stopped if no benefits are seen during that period of time.

Side effects of inhaled corticosteroids in very young children include slow growth across all ages. However, poorly controlled asthma also reduces a child’s growth rate. Hence, your primary physician will discuss the risks and benefits of commencing inhaled corticosteroids with you before commencing the medication.

Elderly Patients

Polypharmacy in elderly patients makes treatment in this group challenging. Commonly used drugs like Beta Blockers (for hypertension), aspirin and other NSAIDs (for analgesia) are all contraindicated in the treatment of asthma.

All elderly patients are advised to inform the doctor of all the medications currently consumed.

Side effects from asthma treatment like long time consumption of corticosteroids at high doses include development of osteoporosis and diabetes. Discuss management strategies with your primary physician before commencing these medications.

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