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Is it advisable for children to take so many medicines for allergic bronchitis?

Q: My daughter is 9 years old. She is suffering from allergic bronchitis. Her symptoms get worse when the weather changes. We live in a hilly area. She has been prescribed the following medicines to be used with Rotahaler - Asthalin Rotacaps – Salbutamol Sulphate Rotacap; Beclate – 200 –Beclomethasone Dipropionate Rotacap; Cromal Rotacaps – Sodium Cromoglycate Cartridges; Babudil – Bambuterol Hydrochloride Oral Solution (Liquid Syrup); Montair – 5 Montelukast Sodium Chewable Tablets 5 mg. Can these medicines be used at the age of 9 years? How long can these medicines be used without any addiction? Can we use these medicines without the advice of the doctor whenever required? Can we consider these medicines as steroids, if yes, can these be used for prolonged period?

A:Many doctors in India use the words allergic bronchitis in place of Asthma. All the medicines mentioned in your list are meant for asthma. Beclate is a steroid; others are not. Anti-asthmatic medications have to be taken for prolonged periods. There is a well-accepted internationally-recognised procedure of treating asthma, starting with lowest dose of one drug and increasing if required plus adding new agents if the response is not adequate. In very severe cases, we do need to give five medicines. You may wish to get your daughters case reviewed by a doctor. In general terms we start with (a) inhaled short acting B-2 agonists (such as salbutamol) not more than once daily, (b) add low dose inhaled steroids, twice daily, (c) increase dose of inhaled B-2 agonists and add high dose steroids (d) if still response is not adequate, add slow release theophyllin (e.g. Unicontin-400/600 once daily) and so on.

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