title: [Treatment of asthma in children: more than merely 'puffing'].
abstract: Five children, four boys aged 6, 9, 12 and 13 years and one girl aged 6 years, had persistent asthmatic symptoms despite maintenance treatment with inhaled corticosteroids and short-acting bronchodilators on demand. One of them required the addition of a long-acting beta 2-agonist to become symptom-free. The other four patients did not need to step up their asthma medication after correction of poor inhaler technique, treatment of dysfunctional breathing, treatment of allergic rhinitis, and elimination of passive cigarette-smoke exposure, respectively. All current guidelines on the treatment of asthma in children advise, in case of persistent asthmatic symptoms despite inhaled corticosteroids and short-acting bronchodilators, the addition of long-acting beta 2-agonists. However, various factors may play a role in the persistence of asthma despite adequate therapy and these factors should be evaluated before stepping up the medication.
authors.affiliation: Afd. Kindergeneeskunde, Isala Klinieken, locatie Weezenlanden, Postbus 10.500, 8000 GM Zwolle.
authors.forename: A F
authors.initials: AF
authors.lastname: Brouwer
authors.forename: R J
authors.initials: RJ
authors.lastname: Roorda
authors.forename: P L
authors.initials: PL
authors.lastname: Brand
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000209:etiology / Q000628:therapy*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000628:therapy; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D014028:Tobacco Smoke Pollution