Successful Drug Regimen for Asthma

Tuesday, August 4, 2009, 12:54
Asthma
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TURNER:: Spencer from Seattle is next to join us here on the Asthma Education Network. Welcome Spencer.
SPENCER:: Hi. Thank you.
TURNER:: And what’s your issue with asthma you’d like to talk about?
SPENCER:: Well, thanks for taking my call. I have a five year old son and since the age of two he takes bronchodilators, Albuterol three times a day, Cromolyn twice a day, or I’m sorry, four times a day, and he also takes Azmacort a couple times a day and on occasion, when he has an episode that’s serious, we will put him on a short dose of oral steroid Prelone that will last somewhere between two and five days. My question is, if could you outline the short and long term negative side effects of using those drugs and whether or not there are any real alternatives for him that would be worth looking at.
TURNER:: Before we go to the doctors Spencer, I’m curious about how that impacts your lifestyle. Do you find that’s very restrictive, having him with those medications and that schedule?
SPENCER:: No. When he was first diagnosed with asthma, it was a real scary thing, a real hardship on our lives. We’ve gotten very good at managing it to the point now where we really are able to make a call about using the oral steroids, probably even without the doctor, we obviously do consult with our doctor at some point in the process, but we use the peak flow meter and we have a real good ability to manage it. So he’s only been in the hospital once and that was the first time, when he was first diagnosed with asthma, and I credit that to just having a really good pediatrician and being able to manage it well.
TURNER:: Yeah, I guess you have gotten used to it. How long did it take you to learn that process?
SPENCER:: It was the scary thing for about six months and then I just read up on it a lot and after about six months or a year I started becoming more comfortable with it.
TURNER:: Okay, Spencer, well, Dr. Redding has been giving you thumbs up while you’ve been describing your situations so I’ll give him first shot here.
REDDING:: I congratulate you on what you’ve learned and what you’re doing. Most parents tell us that it takes somewhere between six and twelve months to learn about asthma no matter how much you read. Your child is on a lot of therapy right now and I would say that you might be able to simplify some of that. I would tell you in general, when people look at potency and side effects they think about Cromolyn as having no side effects and not working on everybody. If you start using inhaled steroids that’s a stronger medication, it’s a more effective one if you happen to have persistent symptoms. It has a few side effects, such as thrush, which is a fungus in the back of your throat that you can avoid by using a spacer and perhaps by gargling. But in large part, inhaled steroids are safe. The Albuterol is for symptomatic relief. And I would hope that you can get at some point to using Albuterol not on such a regular basis, but on an as needed basis, because the asthma is under better control. And lastly, in terms of oral steroids, that’s clearly the most potent drug we have and the way you described using it is very, very good. If you use it for short term relief of acute asthma symptoms, you tend to curtail the severity and the duration of the acute asthmatic event. You can clearly prevent hospitalizations, you can also reduce the duration of hospitalization even if your child goes in. You happened to say something that we don’t talk about very much, which is whether you should call your doctor when you use Prednisone. And I think it’s important that if you can’t get a hold of your doctor and you know what to do, that you proceed to start doing it while you’re trying to reach your doctor for additional advice. I think one of the biggest problems we have, whether it’s in children or adults, is that they delay the therapy that they need for the acute asthma when it occurs. And I really congratulate you on the way you’ve developed your program.
SPENCER:: Okay. Thank you.

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