I have – yet again – been prescribed Advair. Unlike previous occasions, I am making a genuine effort to use it regularly. As those of you who use it know, it comes in the form of a measured powder which you suck in through your mouth from a disc-shaped dispenser. Thanks to my crappy lungs, I barely feel like I’m getting any powder out of the damned thing at all, much less sucking it all the way down.
Are the steroids in Advair supposed to work directly on the lungs and trachea, or do they work just as well if they never make it past the tongue? If they need to be applied “to the affected area,” how does ANYONE get any use out of Advair? If we could suck in that well, we probably wouldn’t need the stuff.
Well, if you can draw oxygen into your lungs, you should be able to draw at least some of advair’s active ingredients into your lungs too. And since you’re here typing, I’ll hazard a guess that you’re drawing oxygen.
You are right in that the medicine is no good if you just get it on your tongue. And that was one of the chief disadvantages of the fluticasone (and other steroid) aerosols. Waaaay too much ended up in the nasopharynx, where it gave no benefit.
But Advair powder has been shown by radiolabelled assays to waft gently into the bronchioles where the chronic inflammation which is the hallmark of mild persistant (or worse) asthma does its dirty work. Moderate quantities seem to make it down there just fine even if you can barely blow a 250 on a peak flow meter.
But if you have doubts about your personal ability to get sufficient quantity into your lungs, check with your own doc.
I have had patients who were so tight that inhaled meds didn’t do much good. Generally I ended up using IV or IM steroids on them, until they could breath halfway decently. Then a brief prednisone burst until they could get benefit from something like Advair.
You might want to inquire of your doc if you are a candidate for leukotriene inhibitor meds like zafirlukast or montelukast.
Note: The above applies mainly if you are an asthmatic. If you’ve got COPD or CF or pulmonary fibrosis, consult your pulmonologist for just what you should be doing. Even with those disease tho, Advair should be able to help.
Remember to rinse your mouth after each dose. The stuff that works wonders in your lungs can cause thin tissue in your mouth, so that a handful of Fritos® can give you a cut on your gums. Rinse.
I’ve never used Advair in particular, but I’ve used a few other asthma medicines that are dispensed in the way you describe. In my experience, the amount of powder dispensed is actually very tiny. Apart from a slight taste, there usually isn’t any clue that I got any powder out of it. But it seems to do the job effectively.
Of course, if you are still concerned, see a doctor.
Advair is AWESOME. It’s the best thing I’ve ever used to treat my asthma. Twice a day. I keep it next to my toothbrush in the bathroom so I’ll remember to take it twice a day. The bathroom humidity has yet to be a problem.
Tenar, it sounds like you’re in worse repiratory shape than me, but I’ve found that when my breathing is so shallow I’m worried about my Advir dose being inefective, I can take a shot off my rescue inhaler. That increases my capacity enough to get a good pull off the Advair.
Thanks to all! Actually, my situation probably isn’t that bad compared to a lot of people. I’m just frustrated because I’m one of those people who never had asthma until adulthood, and it pisses me off. (Of course, I live in a moldy house with dogs and cats, so I can’t exactly claim to be mystified as to how this happened.) I’m not sure, but I do feel as if I may be starting to feel the effects of the advair this morning, after about a week or so of use. I’m just impatient, and, I suspect, looking for any excuse to stop taking my meds.
