Key Points of Dr. Williams’ Summary of the 2002 NAEPP Guidelines

Key Points of Dr. Williams’ Summary of the 2002 NAEPP Guidelines

If your child has persistent asthma, the best control medicine is an inhaled corticosteroid.

If your child is five years old, or older, and has been diagnosed with mild persistent, moderate persistent, or severe persistent asthma, talk with your doctor about the kind of controller medication your child is on. The revised 2002 NAEPP guidelines recommend inhaled corticosteroids, a controller medication, over other controller medications such as cromolyn, nedocromil, theophylline or leukotriene receptor antagonists. Inhaled corticosteroids improve asthma control more than the other controller medications.

Inhaled corticosteroids are safe and, over the long run, will not inhibit your child’s growth.

Some parents worry that long-term use of inhaled corticosteroid medications for children with persistent asthma may delay or inhibit growth or decrease bone density. The revised 2002 NAEPP guidelines indicate that long-term use of inhaled corticosteroids produces no clinically important, long-term, irreversible changes in growth or bone density.

Salmetrol and formoterol – long-acting inhaled beta-agonists – work better than leukotriene receptor antagonists or theophylline as add-on medications to inhaled corticosteroids for children age five and older.

If your child is age five or older and has moderate persistent asthma, ask your doctor what kind of medicine may have been prescribed in addition to inhaled corticosteroids. To improve asthma control, the 2002 NAEPP guidelines recommend adding a long-acting inhaled beta-agonist - such as salmeterol or formoterol – rather than leukotriene receptor antagonists or theophylline to low to medium doses of inhaled steroids. Adding an inhaled beta-agonist also works better than doubling the dose of inhaled corticosteroids.

Keep a written asthma plan and take regular peak flow readings if your child has moderate persistent or severe persistent asthma.

Will adding a written asthma management plan to medical treatment offer better control of your child’s asthma than medical treatment by itself? Studies do not yet provide a clear answer. If your doctor has given you a plan be sure to follow it. Is it better to manage asthma based on symptoms or on peak flow readings? Studies show that either way works.