Prevención y cuidado de infantes en crisis asmáticas

Abstract

Asthma is a common chronic inflammatory disorder of the lower respiratory tract in childhood.The treatment of asthma exacerbations and disease control are the main concerns for clinical practice. The Global Strategy for Asthma Management and Prevention are widely accepted documents, frequently implemented, with conflicting advice and different conclusions on the definition and treatment of asthma. The objective of this work is to describe the conventional treatments and some new therapeutic approaches for pediatric asthma according to the guidelines, highlighting the key aspects, and the differences in the clinical recommendations proposed for the management of asthma. Age-specific therapy is proposed in the steps, according to the clinical severity and the level of disease control. If control is not achieved within 3 months, a step up must be considered; otherwise, if control is achieved after 3 months, a step down can be considered. The most commonly used drug classes for asthma medications are beta-2 adrenergic agonists, corticosteroids, and leukotriene modifiers. Intramuscular triamcinolone has been used to treat severe asthma. Chromones and xanthines have been widely used in the past, but have shown the limits related to their efficacy and safety profile. Omalizumab, a monoclonal antibody against IgE, is an immunomodulatory biological agent, used as a new drug in patients with confirmed IgEmediated allergic asthma, only for the patient's specific range of the total IgE level. There is low evidence on the efficacy of methotrexate, as well as macrolide antibiotics in children with asthma.Antifungal agents are also not recommended in asthmatic patients. Non-pharmacological measures that can improve the patient's quality of life should also be tried.