Pediatric Asthma: Quick-Relief Medications


Quick-relief medications are used to treat asthma symptoms or an asthma episode. Quick-relief medications are not a substitute for long-term control medications.

 

Short-Acting Beta-Agonists

Common inhaled beta-agonists include:

  • Proventil HFA®. ProAir®
  • Ventolin HFA® (albuterol)
  • Xopenex® (levalbuterol)
  • Maxair® (pirbuterol)

Short-acting beta-agonists work quickly to relieve asthma symptoms. Beta-agonists relax the smooth muscles around the airways. Your child’s doctor may prescribe a beta-agonist to use as needed to relieve asthma symptoms. If your child uses this medicine for asthma symptoms more than twice a week talk with your child’s doctor. Also talk with your child’s doctor if your child uses more than one metered-dose inhaler a month.

This is a sign that your child’s asthma is poorly controlled and your child’s long-term control medication may need to be adjusted.

 

Anticholinergics

Atrovent® (ipatroprium) is a quick-relief medication. Atrovent® opens the airways by blocking reflexes through nerves that control the smooth muscle around the airways. It is slower-acting than the short-acting beta-agonists and can take 15-20 minutes to show a significant effect. Atrovent® may be useful following an inhaled beta-agonist to achieve a longer-lasting effect, especially during an asthma episode. Atrovent® is available in inhaled forms.

Albuterol and ipatroprium can be combined in one medication. Combivent® is a combination inhaled medicine. DuoNeb® is a combination solution for the nebulizer.

 

Steroid Pills

Common steroid pills and liquids include:

  • Deltasone® (prednisone)
  • Medrol® (methylprednisolone)
  • Orapred®, Prelone®, Pediapred® (prednisolone)

Steroid pills and syrups are very effective at reducing swelling and mucus production in the airways. They also help other quick-relief medication work better. They are often necessary for treating more severe episodes of asthma.

It is important to note that the steroids used in asthma treatment are not the same as the anabolic steroids used illegally by some athletes for body building. Corticosteroids do not affect the liver or cause sterility.

Steroid pills and syrups can be used occasionally in short-term bursts, or as part of the routine treatment for children with severe asthma.

 

Steroid Burst

Many children with asthma periodically require a shortterm burst of steroid pills or syrups to decrease the severity of asthma symptoms and prevent an emergency room visit or hospitalization. A burst may last two to seven days and may not require a gradually decreasing dosage. For others, a burst may need to continue for several weeks with a gradually decreasing dosage. Your child may experience a few mild side effects such as increased appetite, fluid retention, moodiness and stomach upset. These side effects are temporary and typically disappear after the medicine is stopped.

 

Routine Steroids

A small percentage of children with severe asthma require steroid pills or liquid as part of their ongoing treatment. It is important that your doctor prescribe a combination of long-term control medications before recommending routine steroid pills or liquid. Steroid pills or syrups alone should not be used to treat asthma!

The use of long-term oral steroids can be associated with significant side effects. These may include: growth suppression, weight gain, fluid retention, osteoporosis, high blood pressure, cataracts, thin skin, easy bruising, muscle weakness, diabetes, or weakened immune system. Not everyone experiences these side effects, but because of the possible risk, long-term steroid pills or syrups should be continued only when absolutely necessary. We recommend that any child requiring long-term steroid pills or syrups be under the care of a specialist (allergist or pulmonologist).

Steroid pills and syrups can be taken in ways that decrease the risk of side effects. The lowest possible dosage should be used, and it is usually taken in the morning. Your child’s doctor may prescribe long-term steroid pills or syrups every other day (every 48 hours) to decrease some side effects.

Talk with your child’s doctor about side effects and steps to prevent side effects.

 

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