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Does my child with asthma require inhalers forever?

Q: My child (6 years old) is having bronchitis asthma since he was two years old. Now a days though the frequency of the attacks has come down, he gets it when there is any climatic change particularly in winters and the rainy season. He has been prescribed to use the inhaler derihaler-100 mg whenever he suffers from asthma. Now he has also been prescribed to take forair-100 mg. Is childhood asthma curable and does the steroid intake have any side effects?

A:Your child is suffering from mild, intermittent asthma. Such children generally improve in due course and they often become free from the disorder. This is already happening to your child. The treatment of mild, intermittent asthma in children (5-12 years) is internationally codified based on evidence-based medicine. Such children should be given only either short-acting salbutamol (such as Derihaler-100 or Asthalin Inhaler) 3-4 times daily or long-acting salmeterol (such as Salmeter or Serobid) 2 times daily. If the response is not adequate i.e. the patient requires more than 10-12 puffs every day, it becomes necessary to add a steroid such as fluticasone. I hope your child is not taking both i.e. Derihaler and Forair because both contain similar medicine i.e. salbutamol in Derihaler and salmeterol (along with fluticasone) in Forair. Salbutamol and salmeterol both belong to the same group called B-2 agonists. We do not give them at the same time. In conclusion: if the child is responding well to salbutamol alone (i.e. Derihaler), then there is no need to add a 2nd medicine. However if the control is inadequate needing more than 10-12 puffs a day, then a steroid needs to be added. In that event, Derihaler should be discontinued and replaced with a combination product such as Forair.

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