title: Management of asthma in school-aged children and adolescents.
abstract: Asthma is one of the most common childhood diseases in the world and a significant cause of morbidity and health care expenditures. United States and international evidence-based guidelines created and updated in the past 2 decades have significantly improved the consistency and effectiveness of asthma care in children. Assessing severity and monitoring control using the impairment and risk domains is fundamental to effective management. At every visit, the provider should assess environmental triggers and comorbid conditions, review inhaler technique and adherence, and provide an updated asthma action plan. Inhaled corticosteroids remain the preferred controller in persistent childhood asthma; however, especially in young children, a discussion should occur with caregivers regarding possible adverse effects. Similarly, if long-acting beta-2-agonists are added to inhaled corticosteroids at step 3 care and above, the risk of severe asthma-related events should be discussed. Indications for referral to an asthma specialist include difficult-to-treat asthma, step 4 care and above, risk factors for severe asthma related events, subtypes of asthma, and doubts of asthma diagnosis.
authors.forename: Sandy
authors.initials: S
authors.lastname: Durrani
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D015897:Comorbidity; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012307:Risk Factors; D012574:Schools; D012720:Severity of Illness Index; D013334:Students; D016896:Treatment Outcome; D014481:United States
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids