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Hi Doc My Mother Is 60 Years Old Health Problems
Question: Hi doc
My mother is 60 years old
Health problems
Fast heart rate
High blood pressure
Iron deficiency anemia
Asthma
Sleep apnea
She has been taking Angizem CD 90 for Blood pressure and fast heart rate
Folvite as iron supplement
Supradyn as multivitam
For asthma, she is using seroflo 125, she is unable to use CPAP machine so she is not using
she takes Montair LC whenever she feels allergy symptoms
current complain
Feeling breathlessness in night time especially while lying down
feeling of mucus in the back of the throat
wheezing in the night
Please suggest if we need to
1. Change the inhaler ( Duolin OR Ipratropium OR Foracort which one will help and will not increase her heart rate )
2. She took omnicortil 40 mg for 4 days
I got her cbc crp and igg ige and other blood reports done levels are fine but her white blood cells are very high 13500 I am attaching the report kindly guide
Looking for your valuable inputs kindly guide
My mother is 60 years old
Health problems
Fast heart rate
High blood pressure
Iron deficiency anemia
Asthma
Sleep apnea
She has been taking Angizem CD 90 for Blood pressure and fast heart rate
Folvite as iron supplement
Supradyn as multivitam
For asthma, she is using seroflo 125, she is unable to use CPAP machine so she is not using
she takes Montair LC whenever she feels allergy symptoms
current complain
Feeling breathlessness in night time especially while lying down
feeling of mucus in the back of the throat
wheezing in the night
Please suggest if we need to
1. Change the inhaler ( Duolin OR Ipratropium OR Foracort which one will help and will not increase her heart rate )
2. She took omnicortil 40 mg for 4 days
I got her cbc crp and igg ige and other blood reports done levels are fine but her white blood cells are very high 13500 I am attaching the report kindly guide
Looking for your valuable inputs kindly guide
Hi doc
My mother is 60 years old
Health problems
Fast heart rate
High blood pressure
Iron deficiency anemia
Asthma
Sleep apnea
She has been taking Angizem CD 90 for Blood pressure and fast heart rate
Folvite as iron supplement
Supradyn as multivitam
For asthma, she is using seroflo 125, she is unable to use CPAP machine so she is not using
she takes Montair LC whenever she feels allergy symptoms
current complain
Feeling breathlessness in night time especially while lying down
feeling of mucus in the back of the throat
wheezing in the night
Please suggest if we need to
1. Change the inhaler ( Duolin OR Ipratropium OR Foracort which one will help and will not increase her heart rate )
2. She took omnicortil 40 mg for 4 days
I got her cbc crp and igg ige and other blood reports done levels are fine but her white blood cells are very high 13500 I am attaching the report kindly guide
Looking for your valuable inputs kindly guide
My mother is 60 years old
Health problems
Fast heart rate
High blood pressure
Iron deficiency anemia
Asthma
Sleep apnea
She has been taking Angizem CD 90 for Blood pressure and fast heart rate
Folvite as iron supplement
Supradyn as multivitam
For asthma, she is using seroflo 125, she is unable to use CPAP machine so she is not using
she takes Montair LC whenever she feels allergy symptoms
current complain
Feeling breathlessness in night time especially while lying down
feeling of mucus in the back of the throat
wheezing in the night
Please suggest if we need to
1. Change the inhaler ( Duolin OR Ipratropium OR Foracort which one will help and will not increase her heart rate )
2. She took omnicortil 40 mg for 4 days
I got her cbc crp and igg ige and other blood reports done levels are fine but her white blood cells are very high 13500 I am attaching the report kindly guide
Looking for your valuable inputs kindly guide
Brief Answer:
night-time asthma exacerbations
Detailed Answer:
Hello and welcome to Ask A Doctor service.
I have reviewed your query and here is my advice.
From your query, it seems that night time control of her asthma is not adequate.
Her current medicine Seroflo 125 has both bronchodilator and steroidal components. Bronchodilator salbutamol is short acting for upto 4 hrs.
All the listed medicines can increase heart rate. However inhalers are less likely to affect the heat rate as they are not absorbed systemically.
Foracort will better control her night-time asthma exacerbations because its longer acting but has slight risk of increasing heart rate if absorbed systemically.
Otherwise we can first switch to Duolin and then to ipratropium alone. Ipratropium will not decrease mucous clearance from airways. Duolin does not have any steroid component so it may temporarily increase inflammation if not supplemented with steroidal component. So duolin will need to be combined with steroid like fluticasone or budesonide inhaler.
They all have their good and bad points.
I think a nasopharyngeal swab or sputum for culture and sensitivity can be done to rule out any bacterial infection that may be causing high WBC and neutrophil in her.
Hope this helps. Let me know if I can assist you further.
Dr Vaishalee
night-time asthma exacerbations
Detailed Answer:
Hello and welcome to Ask A Doctor service.
I have reviewed your query and here is my advice.
From your query, it seems that night time control of her asthma is not adequate.
Her current medicine Seroflo 125 has both bronchodilator and steroidal components. Bronchodilator salbutamol is short acting for upto 4 hrs.
All the listed medicines can increase heart rate. However inhalers are less likely to affect the heat rate as they are not absorbed systemically.
Foracort will better control her night-time asthma exacerbations because its longer acting but has slight risk of increasing heart rate if absorbed systemically.
Otherwise we can first switch to Duolin and then to ipratropium alone. Ipratropium will not decrease mucous clearance from airways. Duolin does not have any steroid component so it may temporarily increase inflammation if not supplemented with steroidal component. So duolin will need to be combined with steroid like fluticasone or budesonide inhaler.
They all have their good and bad points.
I think a nasopharyngeal swab or sputum for culture and sensitivity can be done to rule out any bacterial infection that may be causing high WBC and neutrophil in her.
Hope this helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
night-time asthma exacerbations
Detailed Answer:
Hello and welcome to Ask A Doctor service.
I have reviewed your query and here is my advice.
From your query, it seems that night time control of her asthma is not adequate.
Her current medicine Seroflo 125 has both bronchodilator and steroidal components. Bronchodilator salbutamol is short acting for upto 4 hrs.
All the listed medicines can increase heart rate. However inhalers are less likely to affect the heat rate as they are not absorbed systemically.
Foracort will better control her night-time asthma exacerbations because its longer acting but has slight risk of increasing heart rate if absorbed systemically.
Otherwise we can first switch to Duolin and then to ipratropium alone. Ipratropium will not decrease mucous clearance from airways. Duolin does not have any steroid component so it may temporarily increase inflammation if not supplemented with steroidal component. So duolin will need to be combined with steroid like fluticasone or budesonide inhaler.
They all have their good and bad points.
I think a nasopharyngeal swab or sputum for culture and sensitivity can be done to rule out any bacterial infection that may be causing high WBC and neutrophil in her.
Hope this helps. Let me know if I can assist you further.
Dr Vaishalee
night-time asthma exacerbations
Detailed Answer:
Hello and welcome to Ask A Doctor service.
I have reviewed your query and here is my advice.
From your query, it seems that night time control of her asthma is not adequate.
Her current medicine Seroflo 125 has both bronchodilator and steroidal components. Bronchodilator salbutamol is short acting for upto 4 hrs.
All the listed medicines can increase heart rate. However inhalers are less likely to affect the heat rate as they are not absorbed systemically.
Foracort will better control her night-time asthma exacerbations because its longer acting but has slight risk of increasing heart rate if absorbed systemically.
Otherwise we can first switch to Duolin and then to ipratropium alone. Ipratropium will not decrease mucous clearance from airways. Duolin does not have any steroid component so it may temporarily increase inflammation if not supplemented with steroidal component. So duolin will need to be combined with steroid like fluticasone or budesonide inhaler.
They all have their good and bad points.
I think a nasopharyngeal swab or sputum for culture and sensitivity can be done to rule out any bacterial infection that may be causing high WBC and neutrophil in her.
Hope this helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doc
Sorry but I am not clear my question is can she do foracort nebulization 2 times a day for 1 week along with livolin once in a day. And the. Switch to inhaler with spacer for foracort 200?
Or she should continue with just one inhaler which is seroflo what do you advice.
Secondly after she has completed the course of omnicortil for 4 days she is feeling better in the night still do you still suggest nose swab for her ?? We had also done chest X-ray and it looks normal
Third may be she completed her Course of omnicortil and then we did cbc and becoz of steroid oral intake the wbc might be showing higher is there a possibility?
We also did her crp and igg and ige profile that is also within limits
Pls advice further
Sorry but I am not clear my question is can she do foracort nebulization 2 times a day for 1 week along with livolin once in a day. And the. Switch to inhaler with spacer for foracort 200?
Or she should continue with just one inhaler which is seroflo what do you advice.
Secondly after she has completed the course of omnicortil for 4 days she is feeling better in the night still do you still suggest nose swab for her ?? We had also done chest X-ray and it looks normal
Third may be she completed her Course of omnicortil and then we did cbc and becoz of steroid oral intake the wbc might be showing higher is there a possibility?
We also did her crp and igg and ige profile that is also within limits
Pls advice further
Hi Doc
Sorry but I am not clear my question is can she do foracort nebulization 2 times a day for 1 week along with livolin once in a day. And the. Switch to inhaler with spacer for foracort 200?
Or she should continue with just one inhaler which is seroflo what do you advice.
Secondly after she has completed the course of omnicortil for 4 days she is feeling better in the night still do you still suggest nose swab for her ?? We had also done chest X-ray and it looks normal
Third may be she completed her Course of omnicortil and then we did cbc and becoz of steroid oral intake the wbc might be showing higher is there a possibility?
We also did her crp and igg and ige profile that is also within limits
Pls advice further
Sorry but I am not clear my question is can she do foracort nebulization 2 times a day for 1 week along with livolin once in a day. And the. Switch to inhaler with spacer for foracort 200?
Or she should continue with just one inhaler which is seroflo what do you advice.
Secondly after she has completed the course of omnicortil for 4 days she is feeling better in the night still do you still suggest nose swab for her ?? We had also done chest X-ray and it looks normal
Third may be she completed her Course of omnicortil and then we did cbc and becoz of steroid oral intake the wbc might be showing higher is there a possibility?
We also did her crp and igg and ige profile that is also within limits
Pls advice further
Brief Answer:
If her symptoms are currently controlled then no change required
Detailed Answer:
Hi again
Thanks for clarifying further.
If her symptoms got controlled with omnicortil, then no further change in treatment is required.
If she is able to inhale well from inhaler, then inhaler can be continued. If she cannot inhale well due to any reason then nebuliser will be more helpful.
I personally suggest using spacer alongwith inhaler.
Regarding foracort or seroflo, her symptoms are controlled now, so she can continue seroflo. For night exacerbations, she could take foracort inhaler twice a day. Mainly these control symptoms.
Yes CBC abnormality could be due to steroid. A repeat CBC in few days will help distinguish this cause. Throat swab may be done after that if WBC still elevated.
Hope this clears your doubt.
Dr Vaishalee
If her symptoms are currently controlled then no change required
Detailed Answer:
Hi again
Thanks for clarifying further.
If her symptoms got controlled with omnicortil, then no further change in treatment is required.
If she is able to inhale well from inhaler, then inhaler can be continued. If she cannot inhale well due to any reason then nebuliser will be more helpful.
I personally suggest using spacer alongwith inhaler.
Regarding foracort or seroflo, her symptoms are controlled now, so she can continue seroflo. For night exacerbations, she could take foracort inhaler twice a day. Mainly these control symptoms.
Yes CBC abnormality could be due to steroid. A repeat CBC in few days will help distinguish this cause. Throat swab may be done after that if WBC still elevated.
Hope this clears your doubt.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
If her symptoms are currently controlled then no change required
Detailed Answer:
Hi again
Thanks for clarifying further.
If her symptoms got controlled with omnicortil, then no further change in treatment is required.
If she is able to inhale well from inhaler, then inhaler can be continued. If she cannot inhale well due to any reason then nebuliser will be more helpful.
I personally suggest using spacer alongwith inhaler.
Regarding foracort or seroflo, her symptoms are controlled now, so she can continue seroflo. For night exacerbations, she could take foracort inhaler twice a day. Mainly these control symptoms.
Yes CBC abnormality could be due to steroid. A repeat CBC in few days will help distinguish this cause. Throat swab may be done after that if WBC still elevated.
Hope this clears your doubt.
Dr Vaishalee
If her symptoms are currently controlled then no change required
Detailed Answer:
Hi again
Thanks for clarifying further.
If her symptoms got controlled with omnicortil, then no further change in treatment is required.
If she is able to inhale well from inhaler, then inhaler can be continued. If she cannot inhale well due to any reason then nebuliser will be more helpful.
I personally suggest using spacer alongwith inhaler.
Regarding foracort or seroflo, her symptoms are controlled now, so she can continue seroflo. For night exacerbations, she could take foracort inhaler twice a day. Mainly these control symptoms.
Yes CBC abnormality could be due to steroid. A repeat CBC in few days will help distinguish this cause. Throat swab may be done after that if WBC still elevated.
Hope this clears your doubt.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
One last doubt here, she shud do seroflo twice a day that all ??
And if required do foracort in night ??
Also for my understanding I want to know whether foracort or seroflo which is more effective and safe kindly help me understand.
And if required do foracort in night ??
Also for my understanding I want to know whether foracort or seroflo which is more effective and safe kindly help me understand.
One last doubt here, she shud do seroflo twice a day that all ??
And if required do foracort in night ??
Also for my understanding I want to know whether foracort or seroflo which is more effective and safe kindly help me understand.
And if required do foracort in night ??
Also for my understanding I want to know whether foracort or seroflo which is more effective and safe kindly help me understand.
Brief Answer:
Seroflo is safer and more effective
Detailed Answer:
Hi
In studies, seroflo is shown to be equally effective and somewhat more safe then foracort. I meant that if seroflo is not working, then switch to foracort. Foracort has more rapid start of action then seroflo.
If seroflo is currently controlling her symptoms well (after course of omnicortil), then continue seroflo for now.
Regards
Dr Vaishalee
Seroflo is safer and more effective
Detailed Answer:
Hi
In studies, seroflo is shown to be equally effective and somewhat more safe then foracort. I meant that if seroflo is not working, then switch to foracort. Foracort has more rapid start of action then seroflo.
If seroflo is currently controlling her symptoms well (after course of omnicortil), then continue seroflo for now.
Regards
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Seroflo is safer and more effective
Detailed Answer:
Hi
In studies, seroflo is shown to be equally effective and somewhat more safe then foracort. I meant that if seroflo is not working, then switch to foracort. Foracort has more rapid start of action then seroflo.
If seroflo is currently controlling her symptoms well (after course of omnicortil), then continue seroflo for now.
Regards
Dr Vaishalee
Seroflo is safer and more effective
Detailed Answer:
Hi
In studies, seroflo is shown to be equally effective and somewhat more safe then foracort. I meant that if seroflo is not working, then switch to foracort. Foracort has more rapid start of action then seroflo.
If seroflo is currently controlling her symptoms well (after course of omnicortil), then continue seroflo for now.
Regards
Dr Vaishalee
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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