Asthma is a recurring condition in which certain stimuli trigger the airways to temporarily narrow, resulting in difficulty breathing. Although asthma can develop at any age, it most commonly begins in children, particularly in the first 5 years of life. Some children continue lo have asthma into the adult years; in others, it resolves. More children than ever have asthma. Doctors are not sure why this is so, although there are theories. More than 10% of children in the United States have been diagnosed with asthma, a 75% increase in recent decades. The rate soars to 40% among some populations of urban children.

Most children with asthma are able to participate in normal childhood activities, except during flare-ups. A smaller number of children have moderate or severe asthma and need to take daily preventive drugs to enable them to engage normal play and other activities.

For unknown reasons, children with asthma respond to certain stimuli (triggers) in ways that children without asthma do not. There are many potential triggers, and most children respond to only a few. Triggers include indoor irritants, such as strong odors and irritating fumes (perfume, tobacco smoke); outdoor pollution; cold air; exercise; emotional distress; viral respiratory infections; and various substances to which the child is allergic, such as animal dander, dust or house dust mites, molds, and outdoor pollen. In some children, specific triggers for flare-ups cannot be identified.

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SALMETEROL is a selective long acting beta -2 adrenoceptor agonist. Provides effective protection against histamine induced bronchodilation . Its effect lasts for as much as 12hrs. Salmeterol is marketed  by GlaxoSmithKline under the brand name SEREVENT . The other popular inhaler Advair is a salmeterol fluticasone formulation.

Salmeterol is used in the treatment of chronic obstructive pulmonary disease (copd) and reversible airways obstructions in asthma. It is available as metered dosage inhaler. Dosage: For Adults: 2 inhalations (50 microgram) twice daily. And for Severe airway obstruction: 4 inhalations (100 micrograms) twice daily.

Contra-1ndlcations of Salmeterol include Hypersensitivity. Special precautions to be taken in patients  and their lung function should be monitored while taking Salmeterol  as it is not a replacement for oral or inhaled corticosteroids but use is complimentary to them. Salmeterol is not designed to relieve acute asthma symptoms. Serevent/ Salmeterol inhalers not recommended for children under 4 years and in Pregnant women & those lactating it should be used only when clearly indicated.
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Side effects of Salmeterol include Tremor, tachycardia, subjective palpitations and headache. Salmeterol has Drug Interactions with steroid and Diuretics causing Hypokalemia. Its Effects are antagonized by non-selective betablockers and less so by cardioselective betablockers.  It also has potentiation of vascular effects with MAOIs and tricyclic antidepressants. In November of 2005, the American FDA released a health advisory alerting the public to findings that show the use of Long-acting ß2-agonists like Salmeterol could lead to a worsening of symptoms, and in some cases death.