Symptoms of an asthma attack vary by person and by age but in general include some of the following:
increased cough
faster breathing
wheezing (whistling sound with breathing)
feeling chest tightness
difficulty being active
Severe symptoms:
very fast breathing
difficulty speaking full sentences
inability to catch one's breath
pale skin
looking scared or anxious
lips turning blue/purple
Look at your Asthma Action Plan
Review symptoms in the YELLOW Zone and RED Zone
Decide which category better fits current symptoms
Follow treatment plan in correct zone
Asthma Action Plans are individualized to each person.
Common quick relief rescue medications:
Albuterol or Levalbuterol
can be puffer (MDI) or nebulizer
use puffer with spacer when possible
common doses are 2-4 puffs or 3mL nebulized every 4-6 hours in YELLOW Zone or 6-8 puffs every 15-30 minutes on the way to the ER in the RED Zone
some brand names are ProAir®, Proventil®, Ventolin®, and Xopenex®
2. Budesonide/formoterol or mometasone/formoterol
both are puffers (MDIs) and should be used with spacer when possible
brand names are Symbicort®, Breyna®, and Dulera®
common doses are 1 or 2 puffs every 4-6 hours
3. Fluticasone (Flovent®) puffer, mometasone (Asmanex® HFA) puffer, or budesonide nebulized
for children who don't take a preventative inhaler when well, you may also give one of these medications when having asthma symptoms
puffers (MDIs) and should be used with spacer when possible
common dose is 2 puffs twice daily for the puffers and 1mg twice daily for nebulized budesonide
Once someone's symptoms improve/resolve, you go back to the treatment recommended in the GREEN Zone of the Asthma Action Plan and stop any YELLOW/RED Zone treatments.
Asthma Action Plan are individualized to each person so please use for reference
Sometimes we must give steroid medication by mouth (usually prednisone, prednisolone or dexamethasone) to prevent the asthma attack from worsening. These medications are usually given once daily. Depending on the severity of the asthma attack and the severity of a patient's underlying asthma, the length of treatment with these medications may vary from 1 day to 10 days.
Oral steroid medications do NOT taste good. For older children/adolescents, I prefer to prescribe the tablet form to avoid/lessen the bad taste. This is usually going to be a prednisone tablet or tablets. For younger children who cannot take tablets, the most common medication will be liquid prednisolone. Having your child drink or eat something right after taking the medication can help eliminate the bad taste quickly. Some children will take the medication more readily mixed with chocolate syrup (which can partially mask the bad taste). Again, each child is different so you may need your own strategy.
The primary goal of asthma treatment for many children is to avoid severe asthma attacks that need oral steroids to resolve. That is why taking your prescribed medications and following your Asthma Action Plan is important.