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Doctors' Answers to "Frequently Asked Questions" - Asthma
Asthma and allergy shots
Answer: Few dangers, although occasional patients will have severe reactions and rare deaths have been reported. Asthma usually doesn't respond very much to allergy shots. Seasonal allergies do and some asthmatics can, but most have little response. Deciding whether you would be the one is difficult. However, if you have severe asthma, which is not responding to treatment, it might be worth trying for a year or so.
Inhalers for Asthma
Answer: You can take Intal several times a day, but, it works before exercise, not afterwards. The Proventil will work at any time, Intal works better as a preventive.
Options for Asthma
Sufferer [posted 12/02/98]
Answer: Have you tried leukoktriene inhibitors? Are you using beta agonists?
Adult Onset Asthma [posted
Answer: You should be on either Fosamax or Miacalcin for your steroid induced osteoporosis. This can occasionally head off further damage. Also, have your physician check your 25, Vitamin D levels to ensure you have enough Vitamin D available. This can be replaced by a drug called Rocalitrol and is also recommended in patients taking steroids.
Vitamin A & E Effects On Asthma [posted
Answer: No obvious effect on asthma, although E would be no harm. Vit A can be toxic in large doses. As to the tendonitis(no bursa in the heel), taking non-steroidal anti-inflammatories like motrin and the like would be helpful. Double the over the counter dosage is usually close to prescription doses. Gi toxicity is the concern, stop with any nausea or heartburn.
Asthma - Accolate, Oral Steroids and
Flovent [posted 8/13/98]
Answer: I'd restart his Accolate first. I doubt that this would cause the mental disturbance that you are seeing. Steroids are notorious for this (mainly high dose systemic steroids - not inhaled). Consequently, secondly start an inhaled steroid after you ensure that Accolate isn't doing it, but start with a low dose steroid first and work up slowly.
Asthma and Bronchodilators
Answer: This involves breathing/blowing into a tube and measuring lung volumes. Then one is administered a bronchodilator and the test is repeated to see if these produce any change. There are several measures of lung volume/compliance that are achieved from the computer read pulmonary tests. It basically tests whether you respond to bronchodilators at all with your asthma.
Asthma Medication [posted
Answer: Inhaled steroids are generally not absorbed into the body and as a consequence the systemic side effects are few. However, about 1% of patients will experience the systemic side effects of inhaled steroids - worsening as the dosage or frequency is increased. Steroids can definitely have effects in children, changing their growth patterns, etc. On rarer occasions they would affect the personality of an individual, but theoretically possible. It should be well tolerated if not used excessively, however, it is a great asthma drug and one needs to balance the risk of the steroid against the problems of not being able to breath. Patients still die from asthma, it is not a benign disease.
Asthma and Aerobic Oxygen [posted
Answer: In general, oxygen would not help asthma - only supplement the body during low levels due to asthma exacerbations. Whether it would help depends a great deal on the arterial oxygen levels, not the amount of lung left.
Asthma Medications [posted
Answer: It depends a lot on the severity of your asthma. What are the medications in the 5 inhalers? Also, how often and how long have you been on steroids? When was the last time in patient with asthma?
Answer: This is new to me. It also comes in tablets. However, the drug has not been used extensively in the last few years due to better drugs coming on the market. Maybe you should investigate these and different ways to treat your asthma.
Answer: Asthma is a disease of the airways to the lung. It is due to spasm or narrowing of the airways after stimulation by one of many factors. It is usually reversible so that the airway returns to normal after a period of time. It is one of the more common medical problems and is a leading cause of loss of work and school time. In severe cases, it can lead to death and often limits an individual's activities. Asthma is classified in several ways, but generally falls into allergic and non-allergic types. Allergic is generally seen in young children and teen-agers. Non-allergic is typically seen in older individuals, although there is a wide spectrum of distribution. However, both are due to the hyper-irritability of the airways. Different common triggers include allergens, exercise, cold, chemicals, aspirin, beta- blockers, infections, emotional triggers, and work exposures. Treatment centers on reversing the spasm of the airways. This can be accomplished by one of several drugs. Preventive medications prevent the cold, exercise or whatever from triggering the asthma. These are drugs like cromolyn sodium, occasionally steroid, and occasionally drugs like Valium. Other drugs are used during a spell while the spasm is present. These fall into beta-agonists (inhalers or pills like metaproterenol, etc.), adrenergic drugs like epinephrine etc., methyxanthines like theophylline (caffeine is a weak methyxanthine), and lastly steroids. Steroids have been used in increasing amounts over the last few years as the element of inflammation has been more clearly recognized as a component in asthma. Steroids are usually given as an inhaler, but can be used as system pills in severe disease. These have long term side effects when given as pills. Unfortunately, I doubt that there will ever be a cure for this disease, but there may be better treatments in the future.
Answer: These are three different types of medication. The inhaler is merely a delivery system to deliver these medicines to the lung. These are common medications used in asthma and are complimentary medications-- many asthmatics would take this combination.
Answer: Asthma, by definition, is a reversible airway disease. Consequently, asthma will not cause permanent lung damage. Other lung conditions can.
Answer: Not usually, but occasionally the binder or coloring can cause allergic reactions. Companies usually test these so that they do not produce allergic or asthmatic response, but there are occasional problems with these materials.
Answer: The earlier that asthma arrives usually the more severe it will be. I have not seen your son, but I suspect that you will see a large difference with air conditioning. There is no absolute way anyone can say with absolute certainty that it will help.
Answer: It is not very common to hear of hoarseness with these inhalers. The exception would be your steroid inhaler,beclovent. It is common to develop thrush-usually a mouth soreness- which can he prevented by rinsing the mouth with water and spitting after the beclovent. Hoarseness is usually due to post-nasal drip, acid reflux or other causes. I'd recommend a course of anti-histamines at bedtime as well as an H2 Blocker like Tagament or Axid. If you get no improvement in 2-3 weeks consult your physician.
Answer:Vasotec is not a treatment or a cure for asthma. However, there are some patients who have mild heart failure and wheeze or cough. This is referred to as cardiac asthma. Without knowing your previous cardiac function it is difficult to assess this. Also, some patients will continually aspirate small amounts of food and acid while asleep-as a cause for asthma. A time tested remedy for this type of asthma trigger is losing weight. Possibly, your losing weight has reduced your nocturnal aspiration and the asthma trigger.
Acute Asthma Complications
Answer: Accolate is chemically much different from Zileuton. I'd certainly try it, knowing that you might have the same itching. However, I'd had much better luck with Accolate vis a vis side effects. It can be used with Serevent. I'm not sure why you stopped Azmacort(or equivalent) since the side effects here are usually fairly minimal. This also can be used with Serevent and or Accolate.
Answer: This will be a steroid inhaler-a little more potent than current steroid inhalers. This drug is to decrease the inflammation of the pulmonary tree and reduce the thickening that is caused by uncontrolled inflammation. Side effects are less than systemic steroids but are similar. That is, potential diabetes mellitus, bone loss, cataracts, advanced hardening of the arteries. In addition, yeast infections of the mouth called thrush. I doubt that it will be a major advance; but may be of use in selected patients.
Answer: Leukotriene inhibitors are one of the newer types of treatment for asthma. They work by focusing on decreasing the inflammation in the bronchial tree. Leukotrienes are substances secreted by white blood cells as mediators of inflammation. Consequently, by decreasing the amount of leukotriene there will be an improvement in the severity of the asthma. Since steroids are also directed at the inflammatory part of asthma, it is hoped that concurrent use will decrease the need/reliance on steroids. These drugs take a while to work and should be taken at least a month before your decide if they are helpful. They sometimes take up to three months. There are two different drugs approved currently. That is Accolate(zafirlukast) and Zyflo(zileuton).They work on different parts of the leukotriene system; but seem to have similar effects. I would discuss the particular medications with your physician since there is a little variation especially in potential side effects. In general, I use the Accolate due to less potential side effects(especially hepatic).
Answer: No. But, there are times in one's life that there appear to be page episodes than others. Typically, as one ages you may experience times with minor symptoms. However, given the right triggers(dust, infection, etc.) you will probably have asthma later in life.
Answer: Many physicians are increasing the amount of inhaled steroids(not systemic) to treat asthma. Other possibilities include some of the newer agents the leukotriene inhibitors. Steady use of beta-agonists is helpful;but we are using more and more steroid inhalers as initial therapy. Occasionally, a patient will really benefit from cromolyn sulfate or equivalent also.
Answer: Asthma in one so young is very ununusal;but, occurs occasionally. More
commonly it is due to a bronchial infection that needs to be addressed. Aspiration of
gastric fluid is also seen as a trigger. Ensure that you and your wife stop smoking if you
are since any inhalant will exacerbate the problem. If it was my child I would see a
Pediatric Pulmonary specialist to ensure that the diagnosis is correct.
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