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 Health Collections: Childhood Asthma 
Micaela Sullivan-Fowler ©

  Use of anticholinergic bronchodilation in children.
  Rubin BK; Albers GM
  St. Louis University Department of Pediatrics, Missouri, USA.
  Am J Med 1996 Jan 29;100(1A):49S-53S
Ipratropium bromide is a quaternary ammonium anticholinergic bronchodilator with minimal systemic absorption across the blood-airway barrier. Ipratropium bromide has become primary therapy for the treatment of adults with chronic bronchitis, but its use in children has been limited. Ipratropium bromide can be safely used in the management of acute bronchiolitis, recognizing that most infants do not appear to respond to any bronchodilator medication. When used with a beta-agonist bronchodilator for the therapy of acute childhood asthma, ipratropium bromide appears to provide bronchodilation beyond that achieved by either agent used alone. There are insufficient published data to determine the appropriate use if ipratropium bromide in infants with bronchopulmonary dysplasia, although many of those symptomatic after the age of 6 months seem to benefit from either ipratropium bromide or beta-agonists. As ipratropium bromide has no intrinsic anti-inflammatory properties, its role in the chronic therapy of asthma and related disorders is still unclear.

10) TITLE:
  Helping patients live with asthma.
  Rachelefsky GS
  University of California, Los Angeles, School of Medicine, USA.
  Hosp Pract (Off Ed) 1995 Nov 15;30(11):51-6, 59-64
Few patients with asthma receive sufficient basic training in routine self-care. Even young children can learn to keep track of their symptoms, use a peak flow meter, and recognize when bronchodilator and anti-inflammatory drug dosages must be stepped up. Moreover, more than half of patients have chronic inflammatory airway disease, yet most of them are not being treated for the inflammatory component of their disorder.

11) TITLE:
  Asthma update: new approaches and partnerships.
  Rachelefsky GS
  J Pediatr Health Care 1995 Jan-Feb;9(1):12-21
This article provides pediatric nurse practitioners with an update on new guidelines for the diagnosis and management of asthma. These guidelines, published in 1991 and 1992, are changing the way asthma is managed in the United States. The article highlights portions of the guidelines, with special emphasis on pediatric implications.
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