Using Bronchodilators and Anti-inflammatories

Monday, August 3, 2009, 12:51
Asthma
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TURNER:: Elizabeth from Anacortes. Welcome, Elizabeth.
ELIZABETH:: Hi.
TURNER:: How are you?
ELIZABETH:: Well, I’m doing pretty good tonight, thanks.
TURNER:: Great. What’s the issue with asthma you’d like to talk about?
ELIZABETH:: Well, I’m using my inhalers four times a day, both the Azmacort and my bronchodilator, and that’s a big drag. Well, I read just a blurb in a magazine about Accolate, what I read, was that it can reduce the need for the inhaled medication. And that interests me because, as I say, I am using them so many times a day it would be nice to cut down if I could.
TURNER:: Okay. Dr. Redding?
REDDING:: There are several things about Accolate that are important. The first is that because it’s a pill, as opposed to an inhaler, people are more likely to take it. One of the things we know about Accolate is that it clearly improves symptoms in mild asthma. It’s not meant, however, to be an anti-inflammatory and it’s not meant to really substitute for the anti-inflammatory medicines, such as Cromolyn or Nedrocromil, or any of the steroid preparations that one inhales. So I would look upon it as something that would help you to alleviate symptoms, but it won’t necessarily treat the underlying asthma.
TURNER:: And Dr. Stempel?
STEMPEL:: Well, I think the other thing is that most of the inhaled corticosteroids, drugs like the Azmacort that you talked about or the newer drugs like Flovent, those drugs can be used twice a day and used twice a day very, very effectively. The other drug that’s used effectively twice a day, if the inhaled corticosteroid alone doesn’t control your symptoms well, is the long acting bronchodilator. So lots of times what we’ll do is we’ll have patients who will use their anti-inflammatory, their Azmacort or Flovent, twice a day and then we’ll also use a long acting bronchodilator twice a day like Serevent. And that combination for many people seems to be very, very effective.
ELIZABETH:: I have actually discussed Serevent with my physician and I’d like your thoughts on that too?
REDDING:: Serevent is a very useful medication, I think particularly for nighttime symptoms when you want to sleep all through the night instead of having asthma in the middle of the night. Serevent is a bronchodilator and you should think about it as such. The trouble we get into is when people use a better and better bronchodilator and forget to use their anti-inflammatory agents, then they really aren’t doing themselves a service. So I think as long as you’re compulsive taking your anti-inflammatory agent, like your Azmacort for example, then Serevent is a very, very helpful drug.
TURNER:: Does that answer your question, Elizabeth?
ELIZABETH:: It does. Thank you very much.
TURNER:: Thanks for taking part in the program.

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