Asthma Chronic inflammatory disorder of the airways in which many cells play a role.

. In susceptible children, inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or early in the morning o These episodes are associated with airflow limitation or obstruction that is reversible either spontaneously or with treatment. Childhood asthma may be manifested in 2 primary types: o Recurrent wheezing in early childhood which is usually precipitated by a viral respiratory tract infection. o Chronic asthma associated with allergy persisting into late childhood and often adulthood. Four categories: intermittent, mild persistent, moderate persistent, and severe persistent. The mechanisms responsible for the obstructive symptoms in asthma include: (1) inflammatory response to stimuli; (2) airway edema and accumulation and secretion of mucus and (3) spasm of the smooth muscle of the bronchi and bronchioles, which decrease the caliber of the bronchioles. Exacerbations are episodes of progressively worsening shortness of breath, cough, wheezing, or chest tightness or some combination of these changes. The clinical manifestations of asthma are dyspnea, wheezing, and coughing. In infancy an attack usually follows a respiratory tract infection. Younger children have a tendency to assume the tripod sitting position. Infants and small children are restless, irritable, and unable to be comforted. Infants may display supraclavicular, intercostal, suprasternal, subcostal, and sternal retractions. Because infants have more pliant chest, a prolonged expiratory phase may not be easy to observe Barrel chest, posturing, type of breathing The overall goals of asthma management are to maintain normal activity levels, maintain normal pulmonary function, prevent chronic symptoms and recurrent exacerbations, provide optimal drug therapy with minimal or no adverse affects, and assist the child in living as normal and happy a life as possible. Pharmacologic used to prevent and control asthma symptoms, reduce the frequency and severity of asthma exacerbations and reverse airflow obstruction. Long term control medications to achieve and maintain control of inflammation. Quick relief medications to treat symptoms and exacerbations. Often used in combination

Adenovirus Adenoviruses are common viruses that can cause illness in humans. But, most illnesses are not serious. Adenoviruses most often cause respiratory illness. Infants and people with weakened immune systems or existing respiratory or cardiac disease are at higher risk of getting sick from an adenovirus infection.

Symptoms: Colds, Sore throat (pharyngitis), Bronchitis, Pneumonia, Diarrhea, Pink eye (conjunctivitis), Fever, Bladder inflammation or infection (cystitis), Inflammation of stomach and intestines (gastroenteritis), Neurologic disease

Treatment for respiratory infection may include: increased fluid intake Keeping your child well hydrated by encouraging fluids by mouth is important. If necessary, an intravenous (IV) line may be started to give your child fluids and essential electrolytes. Medication: Pulmocort, o Inhaled glucocorticoid o Formulation (pulmicort flexhaler: DPI 90 or 180 mcg/inhalation) o Formulation (pulmicort respules: suspension for nebulizer) o Dosage 500-1000 mcg/day (1-8 yr old) o Work by suppressing inflammation. o Adverse affects are oropharyngeal candidiasis, and dysphonia (to reduce gargle after each administration and employ a spacer device during administration) o Glucocorticoids can slow growth in children but these drugs do not decrease adult height. Short term studies have shown that they retard growth. However long termindicate that adult height is not reduced albuterol q3h o beta2 agonist are employed for quick relief and long term control in asthma. Short acting o SABA taken PRN to relieve an ongoing attack o Adverse effects: are usualy well tolerated. Systemic effects are tachycardia, angina, and tremor usually minimal o Fror drug administration with an MDI or DPI, the usual dosing schedule is 1 or 2 puffs 3 to 4 times a day nasal saline PRN o If you suffer from chronic or acute sinus infections, sinus rinses can be helpful in removing and thinning out excessive mucus.