A 4-year-old child with asthma has daytime symptoms more than twice weekly but not daily, night awakenings 3 to 4 times per month, and normal activity levels. According to GINA guidelines, this child has mild persistent asthma. What is the first-line controller therapy?

• A Montelukast once daily
• B Daily low-dose inhaled corticosteroid ✓
• C Theophylline sustained release
• D Long-acting beta agonist alone

Explanation

Inhaled corticosteroids are the most effective long-term controller medication in childhood asthma and are first-line at every persistent severity level because they reduce symptoms, exacerbations, and airway hyperresponsiveness. Montelukast is an alternative when ICS is refused or unavailable, but it is less effective at controlling symptoms and preventing exacerbations. LABAs must never be used alone without ICS due to increased risk of severe exacerbations.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.