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By Lahiri

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Thus, any child with chronic persistent asthma needs a proper grading and one must closely assign the child in the grade as depicted. e. step up or step down his/her schedule. At this point it is important to review the pharmacological aspects of the anti-inflammatory, anticholinergics, methylxanthines and the bronchodilators. 1: Classification of severity of chronic persistent asthma Grade Day Mild intermittent Mild persistent Moderate persistent Severe persistent Symptoms Night < 2 times/ week Asymptomatic normal PEF between attacks Attack (hrs, days) < 2/week, < 1/day Attacks affect severity Daily, short acting b2 daily Attacks > 2/ week Lasts days Continuous Limited physical activity.

Maintain normal activity levels. 3. Maintain near normal pulmonary function. 4. Prevent recurrent exacerbations and minimise the need for emergency visits and hospitalisation. 5. Provide optimal therapy with minimal or no side effects. 6. Meet patients’ and families’ expectations of and satisfaction with care. Thus, any child with chronic persistent asthma needs a proper grading and one must closely assign the child in the grade as depicted. e. step up or step down his/her schedule. At this point it is important to review the pharmacological aspects of the anti-inflammatory, anticholinergics, methylxanthines and the bronchodilators.

A recent meta-analyses do not demonstrate a negative effect on growth with dosages of 400-800 μgm/day. Bone Metabolism/Osteoporosis Low and medium dosages of inhaled corticosteroid appear to have no major adverse effects on markers of skeletal metabolism viz serum osteocalcin. Serum alkaline phosphatase and urinary hydroxyproline: creatinine ratio. Elderly female patients may be more at risk due to preexisting osteoporosis, previous use of steroids, a sedentary lifestyle and the normal changes of oestrogen in ageing that effect calcium utilization.

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