|© Micaela Sullivan-Fowler|
Asthma medications for children: guidelines for the primary care practitioner.
School of Education, New York University, New York, USA.
J Am Acad Nurse Pract 1996 May;8(5):243-52; quiz 253-5
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(There was no abstract included with this citation, but the title made it sound useful.)
Long-, intermediate- and short-term growth studies in asthmatic children treated with inhaled glucocorticosteroids.
Department of Paediatrics, Aarhus University Hospital, Denmark.
Eur Respir J 1996 Apr;9(4):821-7
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During recent years, new auxological techniques have been introduced for assessment of the risk of growth suppression in asthmatic children treated with exogeneous glucocorticosteroids. Assessment of lower leg growth rates with the knemometer has made short-term studies of growth processes under strictly controlled conditions possible. However, short-term lower leg growth rates cannot be used for estimations of intermediate-term height growth rates or long-term evaluations of final height. Consequently, the distinctions between the various types of growth studies in asthmatic children treated with inhaled glucocorticosteroids have become important and need to be discussed. The present paper presents a review of the long-, intermediate- and short-term growth studies available. The bulk of evidence from intermediate- and short-term evaluations indicates that growth rate is not affected when standard paediatric doses of inhaled glucocorticosteroids are used. However, further focus needs to be placed on differences between specific glucocorticosteroids, doses and delivery systems. Intermediate- and short-term growth data should be evaluated in the long-term
Aerosol delivery systems for bronchial asthma.
Ariyananda PL; Agnew JE; Clarke SW
Department of Thoracic Medicine, Royal Free Hospital, London, UK.
Postgrad Med J 1996 Mar;72(845):151-6
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Many different inhalation devices are now available for the treatment of asthma. Pressures towards the elimination of chlorofluorocarbon propellants are driving forward development of new devices-as are obvious commercial pressures, including the increased availability of generic formulations. We still, however, often cannot tell exactly where within the lung we want to target a particular medication, be it a bronchodilator or a steroid. The basic processes of aerosol deposition are readily comprehensible. Nevertheless, even under carefully supervised inhalation conditions, one can only roughly estimate where the medication is deposited. We can, however, hope to give our patients good guidance on how to make the best use of a metered-dose inhaler or a jet nebuliser. From the array of available devices, we will increasingly be able to select the most comfortable and convenient for the patient-and therefore most likely to encourage good compliance.