Mr. Asthma

Question:

– Hide quoted text — Show quoted text -> For the last two years I could barely do anything. It was even a chore > to walk across a room. At the time I was averaging about 20mg of > Prednisone a day (sometimes more). I went to a Pulmonologist and he > put me on Serevent 2x a day ( am and pm) and Flovent 110 2  x a day > (am and pm). It is almost like night and day. I can walk up a whole > flight of steps and not have to stop half way up to catch my breath. > I am down to 10 mg of oral Prednisone. The pulmonologist is not real > happy about my last lung test because he thinks I’m about as good as > I’m going to get (too much small air way remodeling) but for the > improvement is fantastic. I sometimes have to use the ventolin in the > pm but I’m still doing much better. >I wonder if there are any asthma suffers out there who even though are >on high doses of Flovent and using Serevent still find they need >Ventolin once a day or more. >I am on 250mcg Flovent 4 puffs/day >Serevent 2puffs/day – morning/ night – might eventually try 2 puffs >just wanted to see how I handle the side effects. >Ventolin – probably about 1 puff/day though sometimes I just put up >with mild asthma symptoms and don’t take the Ventolin for days but I >don’t think this really is the best approach. >I saw my pulmonary doc yesterday and my spirometer values looked good >but I am still wondering about whether I should be using less Ventolin >than I am. I would seem I am at the upper end of how much Flovent I >can take and certainly I have improved from using on average 6-7 puffs >Ventolin a day (an inhaler would last me a month).   Perhaps when I >was holding out using the Ventolin and using Flovent it wasn’t getting >as deep into my lungs as it should have and I am still not getting the >complete benefit of Flovent (yes I use an aerochamber with all my >MDIs). >Another question I have is Serevent usage.  We continually hear how >too much ventolin use is bad and that with Flovent we can reduce >Ventolin usage – but lots of people seem to be on Flovent and Serevent >- so it leads me to believe that Flovent while a good drug really >isn’t all its cracked up to be – it does require for a large number of >us the regular use of a bronchodilator.  What really is the difference >here between Flovent + Ventolin 4-6 times/day and Flovent + Serevent >twice a day?

Before you buy.

Response:

—cut— > Another question I have is Serevent usage.  We continually hear how > too much ventolin use is bad and that with Flovent we can reduce > Ventolin usage – but lots of people seem to be on Flovent and Serevent > – so it leads me to believe that Flovent while a good drug really > isn’t all its cracked up to be – it does require for a large number of > us the regular use of a bronchodilator.  What really is the difference > here between Flovent + Ventolin 4-6 times/day and Flovent + Serevent > twice a day?

A new study indicates Serevent has anti-inflammatory properties in addition to being a bronchodilator. This has previously been shown to be the case with theophylline SR, another long-acting bronchodilator. Using long-acting bronchodilators like Serevent and theophylline SR can reduce the needed inhaled steroid dose. See: http://www.ama-assn.org/special/asthma/newsline/reuters/12027282.htm Salmeterol use reduces airway inflammation in asthma Excerpts: "WESTPORT, Dec 02 (Reuters Health) – The addition of the  long-acting beta2-agonist salmeterol to asthma therapy with  inhaled corticosteroids appears to increase anti-inflammatory  effects, Australian researchers report in the November issue  of the American Journal of Respiratory and Critical Care  Medicine. The investigators conclude that addition of salmeterol is not  associated with increased airway inflammation, "…but  conversely with a complementary antieosinophil effect." " Am J Respir Crit Care Med 1999;160:1493-1499. Ellis

Response:

For the last two years I could barely do anything. It was even a chore to walk across a room. At the time I was averaging about 20mg of Prednisone a day (sometimes more). I went to a Pulmonologist and he put me on Serevent 2x a day ( am and pm) and Flovent 110 2  x a day (am and pm). It is almost like night and day. I can walk up a whole flight of steps and not have to stop half way up to catch my breath. I am down to 10 mg of oral Prednisone. The pulmonologist is not real happy about my last lung test because he thinks I’m about as good as I’m going to get (too much small air way remodeling) but for the improvement is fantastic. I sometimes have to use the ventolin in the pm but I’m still doing much better. – Hide quoted text — Show quoted text – >I wonder if there are any asthma suffers out there who even though are >on high doses of Flovent and using Serevent still find they need >Ventolin once a day or more. >I am on 250mcg Flovent 4 puffs/day >Serevent 2puffs/day – morning/ night – might eventually try 2 puffs >just wanted to see how I handle the side effects. >Ventolin – probably about 1 puff/day though sometimes I just put up >with mild asthma symptoms and don’t take the Ventolin for days but I >don’t think this really is the best approach. >I saw my pulmonary doc yesterday and my spirometer values looked good >but I am still wondering about whether I should be using less Ventolin >than I am. I would seem I am at the upper end of how much Flovent I >can take and certainly I have improved from using on average 6-7 puffs >Ventolin a day (an inhaler would last me a month).   Perhaps when I >was holding out using the Ventolin and using Flovent it wasn’t getting >as deep into my lungs as it should have and I am still not getting the >complete benefit of Flovent (yes I use an aerochamber with all my >MDIs). >Another question I have is Serevent usage.  We continually hear how >too much ventolin use is bad and that with Flovent we can reduce >Ventolin usage – but lots of people seem to be on Flovent and Serevent >- so it leads me to believe that Flovent while a good drug really >isn’t all its cracked up to be – it does require for a large number of >us the regular use of a bronchodilator.  What really is the difference >here between Flovent + Ventolin 4-6 times/day and Flovent + Serevent >twice a day?

Response:

The maximum recommended for flovent is twice the amount you are using.  I would try it to see if that reduces your ventolin, and then titrate down as long as you maintain control.

Response:

I wonder if there are any asthma suffers out there who even though are on high doses of Flovent and using Serevent still find they need Ventolin once a day or more. I am on 250mcg Flovent 4 puffs/day Serevent 2puffs/day – morning/ night – might eventually try 2 puffs just wanted to see how I handle the side effects. Ventolin – probably about 1 puff/day though sometimes I just put up with mild asthma symptoms and don’t take the Ventolin for days but I don’t think this really is the best approach. I saw my pulmonary doc yesterday and my spirometer values looked good but I am still wondering about whether I should be using less Ventolin than I am. I would seem I am at the upper end of how much Flovent I can take and certainly I have improved from using on average 6-7 puffs Ventolin a day (an inhaler would last me a month).   Perhaps when I was holding out using the Ventolin and using Flovent it wasn’t getting as deep into my lungs as it should have and I am still not getting the complete benefit of Flovent (yes I use an aerochamber with all my MDIs). Another question I have is Serevent usage.  We continually hear how too much ventolin use is bad and that with Flovent we can reduce Ventolin usage – but lots of people seem to be on Flovent and Serevent – so it leads me to believe that Flovent while a good drug really isn’t all its cracked up to be – it does require for a large number of us the regular use of a bronchodilator.  What really is the difference here between Flovent + Ventolin 4-6 times/day and Flovent + Serevent twice a day?

Response: