Pediatric asthma patient

The addition of ipratropium bromide to inhaled p2-agonist therapy in acute severe asthma improves pulmonary function and decreases hospitalization rates in both adult and pediatric patients.31 The benefit of combining ipratropium and albuterol appears to be greatest in moderate to severe exacerbations, and the combination should be considered first-line therapy in severe exacerbations. 

Asthma Maintenance therapy in the management of adult and pediatric patients 6 years of age and older with mild to moderate asthma. 

Asthma Prophylaxis and chronic treatment of asthma in adults and pediatric patients 12 months of age and older. 

Pediatric patients with comorbid psychiatric disorders requiring continued treatment for their psychiatric symptomatology (e.g., a schizophrenic patient admitted with an asthma exacerbation)... 

Vourdas D, Syrigou E, Potamianou P, Carat F, Batard T, Andre C, Papageorgiou PS Double-blind, placebo-controlled evaluation of sublingual immunotherapy with standardized olive pollen extract in pediatric patients with allergic rhinoconjunctivitis and mild asthma due to olive pollen sensitization. Allergy 1998 53 662-672. 

Some programs of home care have been applied to pediatric patients. Home care for cystic fibrosis and oncology patients is previously described. Other examples of home care programs in children are patients with asthma that require high technology at home, children with newly diagnosed diabetes,and infants who require neonatal special care and a family support program. 

Examples of these pathophysiologic and pharmacodynamic differences are numerous. Clinical presentation of chronic asthma differs in children and adults. Children present almost exclusively with a reversible extrinsic type of asthma, whereas adults have nonspecific, nonatopic bronchial irritability. This explains the value of adjunctive hyposensitization therapy in the management of pediatric patients with extrinsic asthma. ... 

Fluticasone is a corticosteroid that exerts potent antiinflammatory effect on nasal passages for management of the nasal symptoms of seasonal and perennial allergic and non-allergic rhinitis in adults and pediatric patients 4 years and older (Flonaze) patients requiring oral corticosteroid therapy for asthma (Flovent, Flovent Rotadisk, Flovent Dis-kus) maintenance treatment of asthma as prophylactic therapy in patients 4 years and older (Flovent Diskus, Flovent Rotadisk) and 12 years and older (Flovent). 

One of the major problems in running pediatric clinical trials is the availability of pediatric patients, who tend to be scattered, because they are numerically less likely to have diseases (other than asthma and the usual childhood illnesses). This affects the logistics of screening and subsequent clinic visits. 

Khoriaty E, McQain CD, Permaul P, Smith ER, Ractud R. Intraoperative anaphylaxis induced by the gelatin component of thrombin-soaked gelfoam in a pediatric patient. Ann Allergy Asthma Immunol March 2012 108(3) 209-10. http //dx.doi.Org/10.1016/j.anai.2011.12.012. Epub2012Janl3. 

Other printed materials can be used alone or in conjunction with oral education. Newsletters are published regularly and can be used to convey information addressing specific treatment issues. For example, a newsletter article might address current treatment approaches for pediatric asthma. Because newsletters also contain information that may be of general interest to practitioners and patients, they can have broad exposure. Brochures and booklets can be used to communicate a focused message in an efficient manner. These materials typically are given to people who are expected to have an interest in the topic within. 

No adverse effects were reported in human volunteers exposed to concentrations at 1,000, 2,000, 4,000, or 8,000 ppm for 1 h (Emmen and Hoogendijk 1998). Concentrations of the parent compound in blood appeared to approach equilibrium in <55 min. Following direct inhalation from metered-dose inhalers, no effects were observed in either healthy subjects or pediatric or adult patients with asthma or severe COPD (Smith et al. 1994 Taggart et al. 1994 Ventresca 1995 Woodcock 1995). 

No information on potentially susceptible populations was located for HCFC-141b. A structurally related chemical, 1,1,1,2-tetrafluoroethane, has been tested in metered-dose inhalers for the treatment of asthma. Test subjects included adult and pediatric asthma patients as well as individuals with severe COPD. No adverse effects were reported (Smith et al. 1994 Taggart et al. 1994 Ventresca 1995 Woodcock 1995). The structurally related chemicals trichlorofluoromethane (CFC-11) and dichlorodifluoromethane (CFC-12) are presently used in metered-dose inhalers for the treatment of asthma but are phased out under the Montreal Protocol of 1987 (Alexander 1995). Structurally related compounds including 1,1,1-trichloroethane and trichlorofluoromethane were also tested for cardiac sensitization in a dog model with experimentally induced myocardial infarction. In these experiments cardiac sensitization occurred under the same conditions as in healthy dogs (Trochimowicz et al. 1976). 

Only nine allergic reactions to cuttlefish have been described (Caffarelli et ah, 1996 Ebisawa et ah, 2003 Shibasaki et ah, 1989). One patient was a 10-year-old female who experienced a severe reaction to ingestion of cuttlefish that was manifested by urticaria, angioedema, asthma, abdominal pain, laryngeal edema, and hypotension (Shibasaki et ah, 1989). SPT and RAST were positive. This patient reportedly tolerated octopus, clam, oyster, abalone, mussel, and scallop but reacted to crab and shrimp. Caffarelli et ah (1996) describe a 14-year-old female who had cuttlefish-dependent, exercise-induced anaphylaxis. Ebisawa et ah (2003) reported 7 cases of allergy to cuttlefish among a series of 305 pediatric cases of food allergy but provided no specifics on the circumstances or symptoms of these patients. 

Milavetz G, Vaughan LM, Weinberger E. Evaluation of a scheme for establishing and maintaining dosage of theophylline in ambulatory patients with chronic asthma. J Pediatr 1986 109 351-356. 

With this in mind, Dr. Brouchard thought of some ideas for value-added pharmacy services that he could pursue. While his pediatric asthma service was not successful, perhaps he could offer the same service to an adult population. He had seen a report on the local news mentioning that the prevalence of asthma had increased greatly in their area over the last several years. Like many other pharmacies serving patients of the baby boom generation and older, his pharmacy dispensed many prescriptions for hypertension and... 

An asthma DM program can assist pharmacists in providing education to patients with asthma. Hunter and Bryant developed an educational intervention administered by pharmacists and targeted at pediatric asthma patients and their parents. The educational intervention consisted of a 45-min presentation, a demonstration of drug delivery devices, and a discussion session for participants to ask questions and share experiences. All the participants indicated on a questionnaire that they had received enough information to safely and effectively administer asthma medications. 

Most medications have shorter half-lives in children than in adults, and therefore children may need sustained-release products to maintain serum concentrations in the therapeutic range. For example, a sustained-release theophylline product may be needed for a child with asthma. It may need to be administered every 8h to the child as compared to every 12 h for a healthy, non-smoking adult to maintain therapeutic serum concentrations. When choosing a sustained-release theophylline preparation for a child, it must be remembered that because of differences in release properties, theophylline sustained-release products are not interchangeable. A product selected for the pediatric asthma patient should be reliably absorbed with a minimal serum concentration variation and not a preparation that has exhibited a difference in bioavailability when administered with or without food.[ > - ]... 

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