Asthma deaths in children in the UK: the last straw!

Mark L Levy; Louise Fleming; Andrew Bush

doi:10.3399/bjgp24X738201

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Asthma deaths in Children in the UK: the last straw!
Nigel J. Masters

Published on: 07 June 2024
Asthma deaths in children in the UK: the last straw!
Alan M. Edwards

Published on: 06 June 2024

Published on: (7 June 2024)
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Asthma deaths in Children in the UK: the last straw!
Nigel J. Masters, Retired GP and Medical Summariser, Highfield Surgery, Highfield Way, Hazelmere, High Wycombe HP15 7UW
On a home visit in 1980's London to an Asian mother and her young child I mentioned that I was impressed with the improvement in their asthma control. I asked how this was achieved and was presented with a straw by the young child! He then proceeded to open the junior Ventide® (a combination of salbutamol and beclomethasone) rota-capsule and fit the straw into the capsule. It was a snug fit. He then simply sucked the powder up into his lungs. His mother also used the same regime! I remember being impressed by the simplicity of this approach to the family asthma inhaler routine despite the fact it seemed to break many existing guidelines!

Contrast this little case history with the overcomplicated advice offered today with a plethora of inhaler devices and different inhaler pharmaceuticals driven by the marketing departments of the companies involved in supplying asthma treatments. This pharmaceutical cornucopia is really the elephant in the room. Asthma care needs simplification and standardisation but that is unlikely to be possible as market forces are just far too powerful.

Competing Interests: None declared.
Published on: (6 June 2024)
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Asthma deaths in children in the UK: the last straw!
Alan M. Edwards, Retired GP and pharmaceutical physician., None
Dr Mark Levy's report on asthma deaths in children is a sad reflection on the state of the health service today. Can I suggest that consideration of the re-introduction of in haled sodium cromoglicate be considered for any child who has one attack of severe asthma. If so, it should be a product that provides an adequate dose and adequate distribution in the bronchial tree. Such a product would be the 4% nebuliser solution developed in the USA. This had an excellent pharm-kinetic profile The final sodium cromoglicate inhaled products did not. Inhaled sodium cromoglicate provide protection against atmospheric pollutants and it has been shown to be syncretistic with steroids. It could well provide additional protection for children at risk.

Competing Interests: Pharmaceutical Physician at Fisons Ltd. the developers of inhaled sodium cromoglicate. Consultant to the US company that developed the 4% nebuliser solution.