Asthma medications and children

Seven's On Call with Dr. Jay Adlersberg
November 13, 2007 9:00:00 PM PST
There are new concerns surrounding a popular drug to treat asthma in children.Seven's On Call with Dr. Jay Adlersberg.

Asthma patients face a drug dilemma, since there are only three type of drugs that can prevent attacks. One drug is Serevent, which stops the narrowing of the lungs and air passages that causes symptoms of wheezing. Adults have been warned of some problems with that type of drug. Now, the FDA is extending the warning to children.

Oral steroids, which is basically cortisone, is what Monica Bermudez has needed for 18-month-old Amir. The toddler has been having severe asthma episodes, and it's one of the drugs that works when he has a bad attack.

"He usually has a hard time breathing," Bermudez said. "I can notice the rise and fall of his chest and we usually end up in the emergency room."

Keeping kids out of the emergency room is the job of Sevevent, which is used daily by some kids with asthma to prevent attacks. But now, the FDA has issued a warning about it.

They say the drug can result in a four-fold increase in asthma deaths in kids and increased hospitalizations.

Adult asthma patients have used the drug for years and were similarly warned in 2005. Dr. Umit Emri, of Long Island College Hospital, says the problem with Serevent is that the patients who were harmed were not following the package directions.

"A good number did not follow the recommendations," she said. "And in a subgroup of patients, it was clear that it was a misuse of medication."

Serevent works by keeping the lung airways expanded over the whole day, and its appropriate use can reduce acute asthma attacks.

There are only a couple of types of drugs designed to prevent asthma attacks in kids, and Dr. Emri says she hopes the FDA will not take the drug off the market.

Though the FDA did not take it off the market, she feels that doctors must now better educate parents in the use of the drug.

"They should under no circumstances adjust the medication dose themselves without the physician's guidance," she said. "And when in doubt, they should seek medical attention.

The FDA generally follows the recommendations of its special committees. The special committee of experts apparently balanced the potential harm of Serevent with its ability to save children from the disability caused by repeated severe asthma attacks.

For more information, visit:
National Institutes of Health: Asthma guidelines

National Heart, Lung and Blood Institute

National Library of Medicine: Asthma Take Charge of Asthma