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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Asthma, Persisting Cough, On Salbutamol Inhaler, No Improvement With Fostair. Medicine Options?

my asthma is out of control and i have been swapped onto fostair and given a tablet to take at night but it is having no effect. i am still having to take my salbutamol inhaler 8-10 times a day minimum. The salbutamol only helps for about 15-20 mins and then i am back coughing again. Is there a different fast acting reliever i can ask my GP about?
Mon, 18 Jun 2012
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General & Family Physician 's  Response
Hello,
After going through your history I am of the opinion that the treatment you are receiving for your asthma is inadequate.
While treating asthma we usually follow a step wise approach where we initially start with short acting inhalers of bronchodilators like salbutamol or terbutaline as you are using here, then if the symptoms not adequately controlled we add low dose inhalational steroids as you are using fostair which contains inhalational steroids, if the symptoms are not adequately controlled with this we add long acting bronchodilators (fostair contains formoterol which is a long acting bronchodilator) and if the symptoms are not controlled with this then the next step is to increase the dose of inhalational steroids that is using high dose inhalational steroids and then if symptoms not adequately controlled even with this finally oral steroids are added. All these are added in a step wise approach.
Now in your case you are already on short acting inhalational bronchodilator + low dose inhalational steroid + long acting bronchodilator, next step will be to use high dose inhalational steroids and then if required oral steroids under the guidance of your doctor.
And also addition of antileukotrienes and mast cell stabilizers may help.
It is very important to control or stay away from factors which increase your symptoms.
Ask your doctor if the way in which you are using the inhaler is the right way or not, which is very important.
Finally, follow the treatment regimen strictly.

Wish you good health.
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Asthma, Persisting Cough, On Salbutamol Inhaler, No Improvement With Fostair. Medicine Options?

Hello, After going through your history I am of the opinion that the treatment you are receiving for your asthma is inadequate. While treating asthma we usually follow a step wise approach where we initially start with short acting inhalers of bronchodilators like salbutamol or terbutaline as you are using here, then if the symptoms not adequately controlled we add low dose inhalational steroids as you are using fostair which contains inhalational steroids, if the symptoms are not adequately controlled with this we add long acting bronchodilators (fostair contains formoterol which is a long acting bronchodilator) and if the symptoms are not controlled with this then the next step is to increase the dose of inhalational steroids that is using high dose inhalational steroids and then if symptoms not adequately controlled even with this finally oral steroids are added. All these are added in a step wise approach. Now in your case you are already on short acting inhalational bronchodilator + low dose inhalational steroid + long acting bronchodilator, next step will be to use high dose inhalational steroids and then if required oral steroids under the guidance of your doctor. And also addition of antileukotrienes and mast cell stabilizers may help. It is very important to control or stay away from factors which increase your symptoms. Ask your doctor if the way in which you are using the inhaler is the right way or not, which is very important. Finally, follow the treatment regimen strictly. Wish you good health.