Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Which Is The Medication Suggested For PFT With Reversibility?
Question: This is a follow up question on my brother Asthma condition from childhood which I had asked few days back. I am unable to continue the same question as that question got closed yesterday.
You had suggested a PFT with reversibility. We checked this test in a diagnostic center and they are asking for prescription from a doctor with medicine name.
Please let me know how we can sort it out. Patient Name is XXXX and my email ID is YYYY@YYYY
You had suggested a PFT with reversibility. We checked this test in a diagnostic center and they are asking for prescription from a doctor with medicine name.
Please let me know how we can sort it out. Patient Name is XXXX and my email ID is YYYY@YYYY
Brief Answer:
Commonly used drug for reversibility is Levosalbutamol inhaler.
Detailed Answer:
Hello,
Commonly used drug for reversibility testing is Levosalbutamol inhaler. First do PFT. Then give 2 puffs of Levosalbutamol to the patient. Wait for 10 minutes.
Then again do PFT. Look for increase in FEV1 value by 20% or 200ml.
Hope I have answered your query. I will be happy to help you further. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
Commonly used drug for reversibility is Levosalbutamol inhaler.
Detailed Answer:
Hello,
Commonly used drug for reversibility testing is Levosalbutamol inhaler. First do PFT. Then give 2 puffs of Levosalbutamol to the patient. Wait for 10 minutes.
Then again do PFT. Look for increase in FEV1 value by 20% or 200ml.
Hope I have answered your query. I will be happy to help you further. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
Above answer was peer-reviewed by :
Dr. Remy Koshy
I have attached the report. No difference seen after inhalation. Does this mean it is not reversible at all?
Kindly advise next step of action.
Kindly advise next step of action.
Brief Answer:
His asthma is not reversible.
Detailed Answer:
Hello,
I have gone through the PFT report you have attached. It is clearly showing absence of reversibility. Therefore, his asthma is chronic and not reversible.
He might have to take inhaled treatment for lifelong. It is better to start with tapering treatment suggested by me and see if he is improving or not.
Hope I have solved your query. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
His asthma is not reversible.
Detailed Answer:
Hello,
I have gone through the PFT report you have attached. It is clearly showing absence of reversibility. Therefore, his asthma is chronic and not reversible.
He might have to take inhaled treatment for lifelong. It is better to start with tapering treatment suggested by me and see if he is improving or not.
Hope I have solved your query. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
So, I would try the medication as suggested below.
1. Continue with foracort 200 1 puff twice a day. Montelukast and fexofenadine combination at night. For 1 month.
2. Continue with foracort and change to montelukast 10mg once a day at night for 1 month.
3. Continue with foracort and change to montelukast 5 mg for 1 month.
4. If all goes well then continue with foracort 100 twice daily along with montelukast 5 mg for next 3 months.
5. Then step down to budesonide (budecort) 200 twice daily for 3 months.
6. Then budesonide 100 twice a daily for 3 months.
7. Then budesonide 100 once a day for 3 months.
8. Then budesonide 100 as and when required.
Please see if you can answer the below questions.
1. How serious is the report?
2. Even though it is not reversible, can the above treatment work for some patients?
3. Can this condition become worse as he progress with the age?
4. What precautions he can has to take to manage this condition? He is not taking any precautions as of now except taking 2 puff inhaler at night.
5. Any other permanent treatment to get rid of this?
6. Please suggest the Montelukast and fexofenadine combination tablet name and mg.
1. Continue with foracort 200 1 puff twice a day. Montelukast and fexofenadine combination at night. For 1 month.
2. Continue with foracort and change to montelukast 10mg once a day at night for 1 month.
3. Continue with foracort and change to montelukast 5 mg for 1 month.
4. If all goes well then continue with foracort 100 twice daily along with montelukast 5 mg for next 3 months.
5. Then step down to budesonide (budecort) 200 twice daily for 3 months.
6. Then budesonide 100 twice a daily for 3 months.
7. Then budesonide 100 once a day for 3 months.
8. Then budesonide 100 as and when required.
Please see if you can answer the below questions.
1. How serious is the report?
2. Even though it is not reversible, can the above treatment work for some patients?
3. Can this condition become worse as he progress with the age?
4. What precautions he can has to take to manage this condition? He is not taking any precautions as of now except taking 2 puff inhaler at night.
5. Any other permanent treatment to get rid of this?
6. Please suggest the Montelukast and fexofenadine combination tablet name and mg.
Brief Answer:
This will mostly stay as it is.
Detailed Answer:
Hello,
Answer to your 1st question. According to the PFT report, he has moderate severity.
Answer to your 2nd and 3rd question. With this treatment, he might not progress further. There are very less chances that his lung functions return to normal. Either PFT will stay as it is or it will gradually worse.
In my opinion clinical practice, I have seen many who deteriorate with age. This is because of age related pulmonary changes superimposed on asthma.
Answer to your 4rth question. It is advisable to get done regular PFT (twice in a year). Get done adult respiratory vaccines like influenza and pneumococcal vaccines. Avoid any form of smoking (hukkah, second hand smoke). Prevent dust, chemicals, pollution, fumes by wearing mask. Use air purifier in the home.
Answer to your 5th question. I am sorry to say but there is no permanent cure for this.
Answer to your 6th question. Allegra M, Odimont FX, Montair FX, Telekast F etc., are easily available brands for this combination. He can take any of the above.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
This will mostly stay as it is.
Detailed Answer:
Hello,
Answer to your 1st question. According to the PFT report, he has moderate severity.
Answer to your 2nd and 3rd question. With this treatment, he might not progress further. There are very less chances that his lung functions return to normal. Either PFT will stay as it is or it will gradually worse.
In my opinion clinical practice, I have seen many who deteriorate with age. This is because of age related pulmonary changes superimposed on asthma.
Answer to your 4rth question. It is advisable to get done regular PFT (twice in a year). Get done adult respiratory vaccines like influenza and pneumococcal vaccines. Avoid any form of smoking (hukkah, second hand smoke). Prevent dust, chemicals, pollution, fumes by wearing mask. Use air purifier in the home.
Answer to your 5th question. I am sorry to say but there is no permanent cure for this.
Answer to your 6th question. Allegra M, Odimont FX, Montair FX, Telekast F etc., are easily available brands for this combination. He can take any of the above.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
Above answer was peer-reviewed by :
Dr. Kampana
If he has to take the inhalers life long then as per the treatment plan given by you, at the end he has to take budesonide 100 as and when required. So, do you still advise going through the steps as mentioned below and see how he respond?
1. Continue with foracort 200 1 puff twice a day. Montelukast and fexofenadine combination at night. For 1 month.
2. Continue with foracort and change to montelukast 10mg once a day at night for 1 month.
3. Continue with foracort and change to montelukast 5 mg for 1 month.
4. If all goes well then continue with foracort 100 twice daily along with montelukast 5 mg for next 3 months.
5. Then step down to budesonide (budecort) 200 twice daily for 3 months.
6. Then budesonide 100 twice a daily for 3 months.
7. Then budesonide 100 once a day for 3 months.
8. Then budesonide 100 as and when required.
I am asking this again because as per the plan above we are trying to avoid the regular use of inhalers and use it as and when required.
1. Continue with foracort 200 1 puff twice a day. Montelukast and fexofenadine combination at night. For 1 month.
2. Continue with foracort and change to montelukast 10mg once a day at night for 1 month.
3. Continue with foracort and change to montelukast 5 mg for 1 month.
4. If all goes well then continue with foracort 100 twice daily along with montelukast 5 mg for next 3 months.
5. Then step down to budesonide (budecort) 200 twice daily for 3 months.
6. Then budesonide 100 twice a daily for 3 months.
7. Then budesonide 100 once a day for 3 months.
8. Then budesonide 100 as and when required.
I am asking this again because as per the plan above we are trying to avoid the regular use of inhalers and use it as and when required.
Brief Answer:
If he is doing well in the plan then follow the plan.
Detailed Answer:
Hello,
I have given ideal plan for taper down in asthma treatment. It is not always right for all asthma patients. If your brother is doing well in above plan then stick to the plan.
However, if his symptoms are worsening while tapering down inhaler and oral tablet, he has to increase the dose. In this process, PFT values and symptoms will guide us. Regular 6 monthly PFT is needed.
Hope I have solved your query. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
If he is doing well in the plan then follow the plan.
Detailed Answer:
Hello,
I have given ideal plan for taper down in asthma treatment. It is not always right for all asthma patients. If your brother is doing well in above plan then stick to the plan.
However, if his symptoms are worsening while tapering down inhaler and oral tablet, he has to increase the dose. In this process, PFT values and symptoms will guide us. Regular 6 monthly PFT is needed.
Hope I have solved your query. Wishing good health to your brother. Thanks.
Regards,
Dr. Kaushal Bhavsar
Pulmonologist
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
