Introduction
Asthma is a common condition affecting 10% of adults and approximately 20% of
children in Australia. However, asthma is not a homogenous entity, and many
patterns and subtypes of asthma exist. Patterns may relate to
- frequency of symptoms (infrequent or frequent, episodic or persistent)
or
- season (perennial versus seasonal asthma).
Subtypes of asthma also exist according to precipitating factors such as
- allergy (atopic versus non-atopic asthma),
- work exposure (occupational asthma),
- exertion (exercise-induced asthma) and
- infection (viral-induced asthma).
Asthma may also be classified according to
- severity (mild, moderate, severe, brittle or difficult) and
- response to treatment (steroid sensitive or resistant).
A certain pattern or subtype may occur as a predominant feature of an
individual’s asthma, but significant overlap of patterns or subtypes can occur.
For example, in children the most common pattern is infrequent episodic asthma
associated with respiratory tract infections, but this may co-exist with
exercise-induced or seasonal asthma.
Key messages
-
Aspirin-induced asthma (AIA) is a distinct clinical entity.
-
The development of AIA does not depend on a person having
had previous exposure to aspirin or NSAIDs (non-steroidal
anti-inflammatory drugs)
-
If a patient is already on regular aspirin or NSAIDs for
other reasons, the diagnosis of AIA is very unlikely, and the
medication should not be stopped.
-
Aspirin-sensitive individuals may also be sensitive to
paracetamol at high dose.
-
Aspirin should not be used in children or adolescents under
16 years of age with febrile illness because of the association
with Reye’s syndrome.1
-
Both paracetamol and ibuprofen appear safe in most children,
with no convincing evidence that either is more effective or
harmful.
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