Maintenance Meds on a Toddler

[jayzmom]

I am extrememly concerend that my 26 month old is being over-medicated, and I worry that he may have to pay the price at a later date...

At first we were seeing a doc that told us he had mild/intermittent asthma and had him on Xopenex and Pulmicort when he had cold symptoms (also Extendryl) 2x per day. THe last time he got sick, I was unhappy with the docs attitude so I vowed to switch. (He was on Zithromax, Pulmicort, PediaPred, and Xopenex).

I switched docs and without much hesitation this new doctor has decided to put him on a daily maintenance (even though without a cold he has no symptoms). Is this normal?

I am so worried about giving him Pulmicort/Xopenex and Singulair every day? Any help would be much appreciated... Thanks.

[National Jewish]

If your son has respiratory symptoms twice a week or more or even if he only has monthly episodes but they require increased medications, such as Pediapred, antibiotics and Pulmicort, then it is appropriate to treat him routinely as a preventative measure.  He probably does not need the Xopenex routinely.  That can be given as needed unless he starts having cold symptoms.  At that point it is fine to start giving it several times a day to keep his airways open.  Using an inhaled steroid like Pulmicort routinely in young asthmatics helps prevent remodeling of the airways, which leads to long term, chronic asthma.  
For breathing difficulty many children see their family doctor or pediatrician.  You and your son’s doctor may choose to have him seen by a specialist.  This would be either a pediatric allergist or pediatric lung specialist called a pulmonologist.  We recommend this if any one of the following occurs:
• Severe breathing episode
• Several visits to the hospital or emergency room in the last year
• Frequent treatment with steroid tablets or syrup
• Confusion with the diagnosis
• Allergies are being considered
• Breathing difficulty seems to be getting worse
• Conditions that complicate asthma such as chronic sinusitis, nasal polyps, or vocal cord dysfunction.
When thinking about how often your son has symptoms, be cautious!  Asthma symptoms can be a dry, little cough or a more rapid respiratory rate when he is playing and running around.  It does not have to be wheezing or gasping for breath.
I would highly recommend that you go to our website www.nationaljewish.org and look around the asthma sections.  There is lots of information that can ease your mind and lead you to make good decisions as to what to do next.  

[CINDY4]

Trying to control asthma, certainly can seem like one is on too many meds.  The meds your childs dr has perscribed are all very common for daily maintainence of asthma.  The goal in asthma is to be symptom free long term.  So when you take your preventative drugs and you are symptom free then you know they are working. You know you need stronger doses of your preventative drugs, if you continue to have problems. Since your child has been sick not long ago, the dr will step up his meds so that he does not continue to have asthma flares.  My daughter is a severe asthmatic, and believe me there could be many more meds than what is being used.  Most of your son's meds are inhaled and therefore have very little associated side effects short or long term.  I am not too keen on Singulair for personal reasons associated with the disease my daughter has , but it is very common and I have heard many people tell me it really helped them or their child. Hope this helps.

Cindy