| Introduction | p. iii |
| Preface | p. v |
| Contributors | p. vii |
| Epidemiology of Childhood Asthma | p. 1 |
| Introduction | p. 1 |
| Prevalence of Asthma | p. 2 |
| Incidence of Childhood Asthma | p. 4 |
| Increasing Trends in Prevalence | p. 5 |
| Hospital Admissions for Childhood Asthma | p. 9 |
| Mortality of Childhood Asthma | p. 10 |
| Heterogeneity of Childhood Asthma | p. 11 |
| Risk Factors for the Development of Childhood Asthma | p. 17 |
| References | p. 26 |
| The Natural History of Asthma | p. 41 |
| Introduction | p. 41 |
| Natural History of Asthma in Childhood | p. 42 |
| Summary | p. 64 |
| References | p. 64 |
| Pathophysiology | p. 71 |
| General Overview | p. 71 |
| Pathology | p. 72 |
| Smooth Muscle | p. 72 |
| Airway Hyperresponsiveness | p. 75 |
| Association of Asthma with IgE and Allergy | p. 80 |
| Airway Remodeling | p. 81 |
| Inflammation | p. 84 |
| Conclusion | p. 97 |
| References | p. 98 |
| The Role of Allergy | p. 117 |
| Introduction | p. 117 |
| Evidence for the Importance of Allergy in Childhood Asthma | p. 118 |
| Patterns of Sensitization | p. 121 |
| Avoidance of Early Allergen Exposure | p. 122 |
| Environmental Control Measures | p. 122 |
| Taking an Allergy History | p. 124 |
| Testing for Allergy: In Vivo and In Vitro Tests | p. 124 |
| Allergen Immunotherapy | p. 125 |
| References | p. 126 |
| Pulmonary Function Testing | p. 133 |
| Peak Flow Monitoring | p. 134 |
| Spirometry | p. 140 |
| Periodic Testing | p. 145 |
| Patient Instruction Sheet | p. 146 |
| References | p. 148 |
| Chronic Therapy Overview | p. 151 |
| Epidemiological Considerations | p. 151 |
| Asthma Pathogenesis | p. 153 |
| Recognizing Asthma: History | p. 154 |
| Physical Examination | p. 154 |
| Pulmonary Function Tests | p. 156 |
| Other Laboratory Tests in Diagnosing Asthma | p. 158 |
| Management of Chronic Asthma | p. 161 |
| [beta]-Adrenergic Agonist Bronchodilators | p. 163 |
| Other Anti-Inflammatory Drugs | p. 167 |
| Anticholinergic Agents | p. 169 |
| Antileukotriene Drugs | p. 170 |
| Approach to Therapy | p. 171 |
| The Action Plan | p. 175 |
| References | p. 176 |
| Patient Education in Pediatric Asthma | p. 183 |
| Introduction | p. 183 |
| Pediatric Asthma Self-Management | p. 184 |
| Self-Efficacy and Pediatric Asthma | p. 188 |
| Delivery of Education | p. 190 |
| Patient Education and Adherence | p. 191 |
| Content of Patient Education | p. 195 |
| Preparation of an Asthma Management Plan | p. 195 |
| Conclusions | p. 201 |
| Resources | p. 205 |
| References | p. 207 |
| Psychology of Pediatric Asthma | p. 211 |
| Introduction | p. 211 |
| Pediatric Asthma | p. 212 |
| Asthma and Developmental Psychopathologies | p. 213 |
| Psychosocial Factors in Pediatric Asthma | p. 215 |
| Neurodevelopmental Correlates of Pediatric Asthma | p. 220 |
| Current Conclusions and Further Directions | p. 227 |
| References | p. 229 |
| The Management of Acute Severe Asthma | p. 235 |
| Introduction | p. 235 |
| Epidemiology | p. 236 |
| Pathogenesis | p. 237 |
| Assessment of Acute Asthma | p. 239 |
| Therapy of Acute Asthma | p. 242 |
| Summary | p. 255 |
| References | p. 256 |
| Intensive Care Unit Management | p. 265 |
| Intravenous and Inhaled [beta subscript 2], Agonists | p. 265 |
| Mechanical Ventilation | p. 266 |
| Helium | p. 273 |
| Anesthetics | p. 274 |
| References | p. 275 |
| [beta subscript 2] Agonists | p. 279 |
| Introduction | p. 279 |
| [beta subscript 2]-Adrenergic Receptors | p. 280 |
| The [beta subscript 2]-Agonist Bronchodilators | p. 285 |
| Respiratory Smooth Muscle Relaxation | p. 288 |
| Bronchial Smooth Muscle Desensitization | p. 290 |
| Pharmacokinetics and Pharmacodynamics of Bronchodilation | p. 294 |
| Nonbronchodilator Physiological Actions of [beta subscript 2] Agonists | p. 301 |
| Adverse Consequences of [beta subscript 2]-Agonist Therapy | p. 304 |
| References | p. 309 |
| Glucocorticoids | p. 327 |
| Basic Mechanisms | p. 328 |
| Systemic Glucocorticoids | p. 331 |
| Inhaled Glucocorticoids | p. 337 |
| Adverse Effects | p. 342 |
| Steroid Resistance | p. 348 |
| References | p. 351 |
| Theophylline | p. 363 |
| Introduction | p. 363 |
| Mechanism of Effects | p. 364 |
| Pharmacokinetics | p. 369 |
| Therapeutic Serum Concentrations (Clinical Effects and Therapeutic Range) | p. 386 |
| Toxicity | p. 388 |
| Effects on Behavior and School Performance | p. 391 |
| Clinical Use | p. 392 |
| Place in Therapy | p. 411 |
| References | p. 411 |
| Cromolyn, Nedocromil, Leukotriene Modifiers, and Alternative Anti-Inflammatory Agents in the Treatment of Pediatric Asthma | p. 433 |
| Introduction | p. 433 |
| Cromolyn Sodium | p. 434 |
| Nedocromil Sodium | p. 438 |
| Leukotriene Modifiers in Asthma Treatment | p. 441 |
| Zileuton | p. 443 |
| Zafirlukast | p. 445 |
| Montelukast | p. 448 |
| The Role of Leukotriene Modifiers in the Management of Pediatric Asthma | p. 450 |
| Miscellaneous Immunomodulatory Agents for Asthma | p. 451 |
| References | p. 455 |
| Aerosol Delivery | p. 463 |
| Introduction | p. 463 |
| Determinants of Aerosol Delivery | p. 464 |
| Metered-Dose Inhalers | p. 467 |
| Spacers | p. 472 |
| Dry-Powder Inhalers | p. 474 |
| Nebulizers | p. 477 |
| Aerosols to Ventilated Infants | p. 479 |
| Conclusion | p. 481 |
| References | p. 481 |
| Available Preparations and Usual Pediatric Dosing Range | p. 489 |
| Anticholinergics | p. 489 |
| [beta]-Adrenergic Agonists | p. 490 |
| Corticosteroids | p. 494 |
| Cromolyn and Nedocromil | p. 498 |
| Leukotriene Modifiers | p. 498 |
| Methylxanthines | p. 498 |
| Author Index | p. 501 |
| Subject Index | p. 563 |
| Table of Contents provided by Syndetics. All Rights Reserved. |
