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Saturday, February 16, 2013

Post #37 Asthma: A Pedi Perspective - Part 5 of 5

Frequently Asked Questions:

 I have asthma. Does this mean my child will have it too?

There is definitely a genetic component to asthma, but how big a role genes play is unclear. While there isn't a specific asthma gene, it is more likely that your child will inherit the tendency to develop asthma.

Why does asthma seem to come and go?
Asthma is inflammatory in nature, and there are certain things (triggers) that can cause a flare up.

I don't like the thought of my child being on daily medication. I also worry about the medication losing its effectiveness, and then not working when we really need it to.  Can't he just have meds when he's having symptoms?
Regular use of preventative medications is the best way to calm and prevent flare-ups. If everybody with asthma used the proper medications, the number of hospitalizations and deaths would decrease. Remember, preventative asthma medications are only helpful when used before symptoms begin.  Remember, sunblock only works if you put it on before the sunburn actually occurs.

Will my child outgrow asthma?
Many children will eventually outgrow the propensity to have asthma flare-ups as their lungs mature and their bodies get bigger.  Even then, children who get better with age have a recurrence in adulthood. There is no cure for asthma, although it can be managed and controlled with medication.  The bottom line is that the factors which make a lung asthma-prone can still be present as an adult but the likelihood of flare-ups go down as the lung matures and grows physically larger.

Can food allergies cause asthma?
While asthma is more common in children with food allergies, the presence of food allergies do not guarantee a child will have asthma.

Can the use of asthma medications prevent remodeling changes in the lungs?
Unfortunately the answer is probably not.  More research is needed, but it appears that remodeling changes in the lungs cannot be stopped by diligent use of preventative medications such as corticosteroids - much of this is genetically predetermined.  However, responsible use of asthma medications can decrease the number of bad wheezing episodes and significantly improve the overall quality of life.  How much remodeling matters to overall asthma issues is unclear but we do know that in most children symptoms will improve as they get older.

What is the difference between Albuterol and Xopenex?
Scientifically speaking, Xopenex is just the R-enantiomer of Albuterol, while Albuterol is both a R-enantiomer and S-enantiomer 50:50 mixture.  Practically speaking either medication works as a rescue medication and both are very safe.  Xopenex produces less tachycardia (fast heart rate), however the difference is likely modest.  In children with severe heart conditions it may be necessary to use Xopenex, but for most children either is fine and cost-effectiveness should guide which version of the medication to use.

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