BRONCHIAL ASTHMA

Moderate asthma
More frequent episodes with symptoms persisting and chronic cough
Decrease exercise tolerance
Sometimes needs systemic corticosteroids

Steriods: prednisone (2 mg/kg in ER, then 1 mg/kg daily x 4 days) or dexamethasone (0.3 mg/kg/d) ; in sever disease use IV steroids
Continue to observe- can discharge patient if asymptomatic for 2-4 h after last dose.
Chronic
Education, emotional support, avoid allergens or irritants, develop and "action plan"
Exercise program (eg. Swimming)
Monitor respiratory function with peak flow meter (improves self-awareness of status)
PFTs for children >6 years

Reliever therapy: short acting B2- agonists (salbutamol)
Controller therapy (first line therapy for all children) : low dose daily inhaled corticosteroids)
Second line therapy for children 12 yr: antileukotriene OR long acting B2-agonist in conjunction with low dose inhaled corticosteroids

Indication for hospitalization
Pre-treatment O2 saturation