Long term risks of Drug options

7yr old has bad alergy (allergy) to dust and asthma.  Has pulmicort and albuterol presciption but not taking.  No problems even with exercise, except when at Karate studio twice a week.  Likely dusty air vents.  Option1) No more Karate,  Option2) pulmicort every day to prevent, Option3) albuterol only when wheezing at Karate (0-2X/wk), Option 4) albuterol before Karate to prevent  (2X/wk), Option 5) No drugs since wheezing not too bad.  Which option has the lowest risk factors long term?

[Dr Rajput]

Hi, welcome to the forum, firstly proper assessment and categorization of asthma is essential. They can be categorized from Intermittent, Mild persistent, Moderate persistent to Severe Persistent. There are particular guidelines for the treatment. If one is having attack about 2 or less per week, seems to have intermittent type i.e. mild form.

In such cases, avoid unnecessary use of albuterol, it can be used whenever there is an need of relief of symptoms. Avoidance of the allergen good initial step as it prevents the future attacks. Pulmicort is usually not preferred in mild forms (it can be added esp. if the attacks are more than 2 per week and as maintenance dose).  

Avoidance of allergen is the best option. Second would be use of albuterol to relive the symptoms (whenever there is a attack).

The side effects with albuterol would be increased heart beats, tremors, Dry mouth and Cough. Pulmicort can be associated with Headache, Nasal congestion and Mouth sores but less common.

I suggest you to consult respiratory physician for further information and management. Take care and regards.