Over-Prescribing of Asthma Medications Could be Potentially Lethal to Children
About the Asthma Treatments and Over-Prescribing Problem
According to the Guardian, the reason for the over-prescribing is not clear, but one theory is the use of long-lasting preventative drugs in combination with Ventolin is responsible. Ventolin is a prescription medicine used to treat or prevent asthma, bronchitis, and similar breathing problems.
Peter Van Asperen, who is a professor of pediatrics respiratory medicine at the University of Sydney (and one of the authors of a report on child asthma deaths), expressed concerns that the combination therapy has become first-line prevention therapy in Australia. He pointed out that every few children actually need such therapy.
The two treatment options for asthma include reliever medications, like Beta Antagonist or Ventolin that helps to open up the airways during an acute episode of wheezing and preventive medications, which are used on a regular basis. A Beta Antagonist is a common inhaler used in conjunction with asthma. It is supposed to improve asthma symptoms by stimulating areas in the human airway, resulting in the widening of said airway.
Although these drugs are useful after the first dose, long-term use can cause worsening asthma symptoms. The two drugs can be combined if patients cannot control the disease with simple preventative treatment, but Van Asperen stated that it should only be used as a last resort. Also, the drugs should not be prescribed to children five years and younger.
Van Asperen added that the purpose of a prevention medication is to try and control the underlying inflammatory component of asthma. They are generally used in patients who are having more frequent symptoms. Van Asperen proposed educational strategies to help doctors prepare written action plans for patients, and better promotion of asthma management guidelines to doctors.
Possible Explanations Behind Asthma-Related Child Deaths
A recent review of asthma deaths has revealed a laissez-faire attitude to the disease, with parents failing to consult specialists and young people ignoring the advice of doctors. Other potential factors contributing to an increased risk of death included: asthma medications not being used as recommended, poor asthma control or medication adherence, and a lack of follow-up care.
Premature deaths from asthma are indeed rare, but there has been a rise in recent years in the country. The New South Wales Child Death Review Team annual report 2013, released last October, showed twenty children up to seventeen years of age suffering fatal asthma attacks between the years 2004 and 2013. More troubling is that the report showed a recent spike, with half of the twenty deaths occurring within the past two years.
Apparently, the misuse and overuse of asthma medication is a “widespread” issue. The impact of asthma is greatly underestimated. There is no one-size-fits-all approach, because different people will respond to different treatments in different ways.
Doctors may not be spending as much time getting familiar with asthma, compared to other diseases which they see as more serious and more life-threatening. Parents with children who have asthma should never be complacent and be well-educated about management, treatment and action plans for the common chronic inflammatory disease.
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