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Steroid inhalers

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Allergies
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Red_34
Elite Member
Joined : Apr 2004
Posts : 23581
Posted 4/21/2007 3:56 AM (GMT -8)
My sons asthma has been acting up again probably due to the season change.  And he has been having to use his Albuterol maybe once in the evening but he does cough again quite frequently.  His coughing is not too bad as long as I give him an allergy pill.  But I have a question.  He has an Asmnanex inhaler for his bad times.  He is the type of teen that is not very verbal in telling me his symptoms, I have to keep asking him questions - it's like pulling teeth!  At what point do you start using your steroid inhalers?  Is it usually only when you are having symptoms or is this something you use all the time as a preventative?
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mongatu
New Member
Joined : Mar 2007
Posts : 13
Posted 4/21/2007 11:29 AM (GMT -8)
Steroid inhalers are maintenance medication or asthma "preventers." They are usually effective and have minimal side effects if used properly. A person usually has to take them as prescribed for at least a week or two before they will even start to work. Then the person with asthma needs to stay on them every day, usually twice a day, for them to continue to work. After several weeks of using inhaled steroids, if the asthma is well controlled, usually the person will find they can greatly reduce their use of the emergency "rescue" medications such as an albuterol inhaler. Also, once the asthma is under control, one can try to gradually reduce the dose of inhaled steroid to the lowest possible dose that maintains control (i.e., keeps the symptoms from breaking through).

As a general matter, it is very important to keep one's asthma under control so as to minimize asthma exacerbations because recent research indicates that each time a person has an asthma exacerbation, it may cause permanent structural changes (i.e., damage) in the lungs which is not good. This is why it is very important to use the inhaled steroids daily as prescribed even when the person with asthma feels fine.

Good luck.
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stkitt
Elite Member
Joined : Apr 2007
Posts : 32602
Posted 4/22/2007 7:39 AM (GMT -8)
Good Advice you posted Mongotu.
Your right re each attack can cause more damage.
In the ER we sometimes have to give back to back albuterol nebs plus IV meds so if you can keep the asthma under control, you are doing the right thing.
If you feel you need to go to ER just go, no one will be turned away in the USA if they present to the asking to be seen.
This site is great for information shared.
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Red_34
Elite Member
Joined : Apr 2004
Posts : 23581
Posted 4/22/2007 2:56 PM (GMT -8)
Thank you for your responses. I started my son back on the Asmnanex yesterday and even though his attacks are mild, it seems to be working already.
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mongatu
New Member
Joined : Mar 2007
Posts : 13
Posted 4/22/2007 11:14 PM (GMT -8)
Although I personally have a mindset to minimize taking meds, especially steroids, asthma and inhaled steroids are different. The most enlightened advice I have seen given for treating asthma is that it is best to treat it aggressively with inhaled (or in some cases, oral) steroids early on. Unfortunately, many ER's, after stabalizing a patient with asthma, will just release them with an albuterol inhaler and advice to consult the primary care physician if problems persist. They are still reluctant to release a patient with a steroid inhaler. People with asthma really need to get on the inhaled steroids ASAP in order to minimize damaging structural changes in the lungs.

I hope this ER policy changes soon because the longer one waits before getting on the appropriate dose of inhaled steroids, the more permanent damage is done to the lungs. And the downside of taking inhaled steroids is very minimal (compared to oral steroids which, of course, are a whole different ball of wax). Really, if one rinses out the mouth each and every time one takes the inhaled steroids, the side effects are usually very minimal. Very little of the inhaled steroids gets out of the lungs and into one's system. My doc, as well as the research I have seen, says they are safe for long term use, at least for adults. Not sure about children, but I suspect they are worth it for them as well.
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BookLover4life
New Member
Joined : Apr 2007
Posts : 2
Posted 4/28/2007 3:59 PM (GMT -8)
It is true for children as well. When I was first diagnosed at 4, the gave me a steroid inhaler which i used for a long while, an recently i was sick and needed to take 2 puffs twice a day for about a month, and i haven't had any side effects at all. It's unfortunate about that ER thing, because with the steroid inhaler, my doc told me that you should use if for a little while after you get better because otherwise it might just come back.
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ceebee
Regular Member
Joined : Dec 2006
Posts : 401
Posted 4/30/2007 12:20 AM (GMT -8)
Which inhalers are the steroid ones? All these meds are confusing. Is advair a steroid and can you use a steroid inhaler with advair? Summer is coming and I am terrified! Thanks:)
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ceebee
Regular Member
Joined : Dec 2006
Posts : 401
Posted 4/30/2007 12:20 AM (GMT -8)
Which inhalers are the steroid ones? All these meds are confusing. Is advair a steroid and can you use a steroid inhaler with advair? Summer is coming and I am terrified! Thanks:)
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ceebee
Regular Member
Joined : Dec 2006
Posts : 401
Posted 4/30/2007 12:20 AM (GMT -8)
Which inhalers are the steroid ones? All these meds are confusing. Is advair a steroid and can you use a steroid inhaler with advair? Summer is coming and I am terrified! Thanks:)
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Chartreux
Veteran Member
Joined : Aug 2006
Posts : 9664
Posted 4/30/2007 1:41 PM (GMT -8)
Its time for some tough love as well, take him to the doctor tell the doctor he's not in compliance with his medications and have the doctor give him a stern talk to. He's going be and adult someday and he needs to get his asthma under control by himself so your not worrying 24/7. Sorry, if this seems harsh but even young kids should be able to grasp this concept pretty fast, especially if it comes from a doctor. (kids always say but mom and I've had to butt a head or two with my daughter) it hard to be a parent of a child who gets sick but you must not always baby them either. My daughter has a heart condition so I've been there.
The Asmanex is his maintence medication and the albuterol is his short term rescue inhaler, you might want to ask his doctor about a longer lasting rescue inhaler and take this question in to his doctor and talk more with the doctor. Make sure you understand what the medication is and how he isto use it before you leave the doctor office. Just trying to help you out. Lots of Hugs and take care
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Red_34
Elite Member
Joined : Apr 2004
Posts : 23581
Posted 5/1/2007 5:06 AM (GMT -8)
Tough love.......I love it! :) And you're right that we sometimes tend to baby our children especially when they have health conditions. I'm so used to handling him with kid gloves because when he was younger, he was emotionally handicapped (due to a chemical inbalance in the brain) and cried easily, got upset etc. if you so much as looked at him funny. Now that he's a young man, he is much stronger emotionally but it's time for Mom to realize that! lol It's a tough habit to break.

Ceebee, you can look up these meds online and find out which ones are steroid but I *think* that Advair is a steroid based inhaler. As for combining steroids, I'm not sure and maybe you should call your doc to be certain.
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mongatu
New Member
Joined : Mar 2007
Posts : 13
Posted 5/3/2007 5:52 PM (GMT -8)
Yes, you can find out everything about meds these days simply by using Google and spending some time reading about them.

Advair is a combination of two medicines, Fluticasone (brand = Flovent) and Salmeterol (brand = Serevent). Fluticasone is a steroid. Salmeterol is a LABA (long acting beta agonist) which acts to relieve constriction in the airways, but it comes on more slowly than albuterol and lasts much longer (8 to 12 hours vs 3 t 4 for albuterol), hence it is not intended to be used as an emergency rescue med. The steroid component, if used regularly, helps to reduce or prevent the inflammatory aspect of asthma from occurring.

So if you are taking Advair, you don't need any additional inhaled steroid since Advair already contains one.

There is some controversy about whether the LABA in Advair is safe for long term use. The general consensus seems to be that it is safe when used along with an inhaled steroid, which of course, Advair contains.

Personally, I'm using just Fluticasone (Flovent) in the morning and Advair at night which is when my asthma is usually worse. This seems to be working out OK for me for the time being. I'm doing this in an effort to limit the use of the LABA (Salmeterol) to when I really need it, which is a night. But, if you've followed this discussion so far, then you will see that I am still getting the same amount of inhaled steroid twice per day that I would be if I was just using Advair twice per day.
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ceebee
Regular Member
Joined : Dec 2006
Posts : 401
Posted 5/3/2007 6:48 PM (GMT -8)
I have fluticasone in a nose inhaler...is that the same as the one you use mon? I am having so much trouble breathing this week and I already take all the meds there are. Thinking I might need hospital emergency if it doesn't start getting better soon. I live in a condo and the dryer vent from down stairs vents through my dryer vent. The vent was clogged and all the downy and water vented into my plac from downstairs.. They fixed it yesterday but the damage was already done for me. I just hate hospitals. I was on prednisone a couple weeks ago for the same vent problem. I hope it is fixed now. Is it too soon for prednisone again?Thanks:)
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dragonfly137927
Veteran Member
Joined : Sep 2006
Posts : 2527
Posted 5/8/2007 9:00 AM (GMT -8)
I take asmanex and it has to be on a daily basis to have any effect. It is a corticosteroid and like other similar inhalers such as advair, flovent, and asmacort it takes at least a few days to kick in if not longer.
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