SAMINA SHAMIM1, S. M WASEEM JAMALVI2, SOBIA QAMAR3,
SYED SANOWAR ALI4

ABSTRACT

Objectives: To determine the frequency of use of long term pharmacotherapy in childhood asthma according to global initiative of asthma (GINA) guidelines. Materials and methods: It was a descriptive study done in the department of Pediatrics, Jinnah Medical College hospital Karachi from October 2005 to September 2006. All children between 1 to12 years, diagnosed as asthma (on clinical grounds) were enrolled. Information regarding asthma severity and use of regular drugs in past 6 months was recorded in a pre-designed Proforma. Disease severity was classified according to GINA guidelines as intermittent and persistent. Persistent group was further subdivided into mild, moderate and severe categories. Treatment in accordance to GINA guidelines was considered as a standard therapy. Results: A total of 150 patients were enrolled, out of which only 4.7% were of intermittent category while 95.3% were of persistent type (39.3% mild persistent, 44% moderate persistent and 12% severe persistent). Patient in intermittent group were not on any regular long term medication. Seventy six percent of the patients with persistent asthma were on quick relief drugs, while controller drugs were being used in19.3% cases only. Limited use of inhalers with or with out spacer device and nebulizers was observed (14% cases). Inappropriate drugs according to GINA guidelines, e.g.: antihistamines, cough and cold preparations, mast cell stabilizers and drugs from hakims and homeopaths, were not included in the study results. Conclusion: Majority of the patients was not found to be treated according to GINA guidelines. Controller medications were being under prescribed while in its place reliever medication was being inappropriately advised on regular basis. Keywords: Childhood asthma, GINA guidelines, controller drugs, reliever drugs, Asthma Pharmacotherapy.

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Prof. Dr. Farah Mansuri
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1 Department of Pediatrics, Liaquat National Hospital & Medical College, Karachi.
2 Department of Pediatrics, Dow University & Health Science, Karachi.
3 Department of Pediatrics, Liaquat National Hospital & Medical College, Karachi
4 Department of Community Medicine, Jinnah Medical & Dental College, Karachi.