Newly diagnosed with asthma, checking in. Just learning about asthma: I had no idea how it worked. I thought: Asthmatic has episode, can’t breathe. Hits puffer thingy. Bronchials clear up immediately, life goes on as before.
Is it just me, or is asthma more chronic than that? I tend to be wheezy for days on end, hit the inhaler every six waking hours and start to feel better after a couple days. I thought those inhalers were like instant cures, but evidently not.
I suppose, like childbirth, asthma is severely misrepresented on TV and in movies.
There are lots of support groups and websites for people with chronic asthma. In general, inhalers are a short term solution. Most doctors will prescibe a regimen of oral steroids to get at the root of the problem.
An inhaler sometimes just makes the problem go away for a while, but it will return when the medication wears off. But your mileage may vary and you should work with your doctor on this asthma. An untreated asthma attack can be very dangerous. Sometimes you will only have one serious untreated asthma attack in your life, if you catch my drift.
As for taking a puff of Primatene if you had no asthma symptoms, I imagine that you would get very revved up. Elevated heart rate and all that. It likely won’t kill you. But I wouldn’t try to take an Olympic drug test afterwards.
Asthma is a chronic progressive disease. Anyone who needs to use a rescue inhaler (like albuterol, or god forbid, primatene) more than once a week should be on a maintenance medication to reduce inflammation and hyper-reactivity of the airways. Rescue medicines just relax the smooth muscle which is squeezing the bronchioles (airways) closed. It wears off in a few hours. It does nothing for the edema and inflammation and mucus that’s built up in the bronchioles, which makes them hyper-sensitive to going into spasm again at the drop of an allergen.
I lack time at the moment, but if you search for my name (QtM) and “Asthma” in GQ, you’ll find rants I’ve posted before on the subject.
My asthma is triggered by allergies, so this happens to me when pollen counts are up and during the winter when all the windows are shut and I’m trapped in there with our three cats. I have good weeks and bad weeks.
Twice I’ve run out of refills on my Albuterol inhaler. Both times I walked up to the pharmacist with Primatine Mist in my hand and asked if he thought I’d be ok if I just used it until I could get a refill. Both times - different pharmacists looked worried, gave me Albuterol and made me promise to get a refill because they couldn’t stand the idea of letting me walk away with Primatine. I always wondered why they still made it available.
I’ve recently started taking Singulair and that stuff kicks butt!
My Doc calls Singulair “Motrin for the lungs”! I’ve got a prescription for the Advair as well. Last year my insurance didn’t cover it, so hopefully this year it will.
Must be nice to be able to keep your patients in a cage where you can keep an eye on 'em.
I have problems with my asthma so rarely I can never find the meds the doc gave me the last time. I’m going in tomorrow a I’ve had a cyhronic cough since a bout with flu so I’ll see what’s the best thing she can give me. Abluterol gives me the heeby jeebies so I’m glad I never self-medicatd with Primatine.
About once or twice a week I’ll get wheezy and have a hard time taking a full breath. I’ll cough and gasp a lot during this time. Usually these periods follow a particularly strong sneeze or a particularly hearty laugh. Asthma? Allergic reaction? Simple difficulty breathing that isn’t related to one of these issues? Who knows. Whatever the problem, Primatine Mist™ works like a charm every time.
So does whatever breathing difficulty I’m having.
So, next time I’m having difficulty breathing, I can:
[ul]
[li]Cough, gasp, wheeze & generally be uncomfortable for a few hours.[/li][li]Take Primatine Mist and be good as new.[/li][li]Hope Dr. Albracht, D.O., prescribes Albuterol or something the next time I see him, which he has already said he won’t do.[/li][/ul]
rasta, it sounds like you need a doc who’ll try to make the diagnosis for you, or at least rule out asthmatic bronchospasm. A methylcholine challenge test would answer a few questions.
And both primatene and albuterol wear off in a few hours. That was my point about rescue medicines.
And if primatene is the only rescue medicine available to you when you need rescuing, use it! But there’s safer stuff out there that works better too.
Thanks QtM. Very helpful. I guess I should have asked my primary more questions, but I didn’t know to ask them! She put me back on Claritin for the allergies – it sounds like controlling the allergies will be the best way to manage the asthma.
You forgot option 4, rastahomie - go see a pulmonologist, even if your primary M.D. won’t refer you and you have to pay for the consult out of pocket.
Please, for your own sake, don’t screw around with this. Your symptoms sound very much like “cough-variant” asthma, and if you’re using Primatene Mist 1-2 times a week you have a potentially serious problem that needs better medical management than what you’re currently getting.
People often take asthma lightly, but it’s a potential killer. Don’t make that mistake. Take care of yourself, and get a proper evaluation of your condition. If you DO have asthma, you need more effective treatments than Primatine Mist, as well as education about the disease so you’ll understand what triggers may set off bronchospasm, and the limitations of inhalers in treating it.
Are long acting “rescue” medications available in the US? For chronic asthmatics, the trend is towards prescribing long-acting rescue medications (with or without preventative medications) act for up to 12 hours, rather than the more traditional short-acting medications such as salbutamol.
Rasta-I second what everybody else says-I currently tell patients that if you are using more than one rescue inhaler yearly then you need better preventative control. If you are using Primatene and it works but your doc does not think you need treatment, I would seek a second opinion.
Regarding “long-acting rescue medications” I think this phrase is a oxymoron. Rescue medications should do just that-they are designed to act quickly in case of emergency. That said, there are long-acting forms of albuterol available in this country. Advair is actually a combination of a steroid and salmeterol, which is a longer acting relative of albuterol, so yes, we do use these in the US.
Advair sounds like the medication marketed under the name Seretide here - which is salmeterol plus fluticasone.
While people here would still use their salbutamol (Ventolin) inhaler in the event of an asthma attack, there has been a lot of concern about people using their rescue inhalers in a prophylactic manner - it was EXTREMELY common until fairly recently for asthmatics to be taking Ventolin every 4 hours and then relying on them in the event of an attack.
Salmeterol (serevent) is a long-acting bronchodilator, NOT to be used as a rescue medicine. It’s quite helpful when used twice a day, especially if combined with an inhaled steroid. Advair combines salmeterol with fluticasone.
I’ve been told that Primatene is not the best thing for anyone, but I still feel “safe” when I have it near. I don’t use it unless I get a bad attack. In the other instances I just get a double shot of espresso, straight up. works every time, for me.
As Qadgop and others have said, salbutamol is NOT a rescue inhaler. It is a B2 agonist (such as albuterol) that was formulated to provide bronchodilation - but it takes 30 minutes to take effect. Many inhaled steroids (fluticasone, triamcinolone, budesonide), as well as leukotrine modifiers (such as Singulair, Accolate, and others) are now viewed as first line agents for the treatment of asthma. These drugs are presented as first line treatment for mild to moderate asthma. Albuterol is a rescue treatment, as is Primatene (hopefully for as few people who suffer with this affliction as possible).
The problem … when I was living in Orlando, I couldn’t find a family doctor; very few were accepting new patients, and the few that were were located close to an hour away in the far northern 'burbs. (I lived in the western suburbs, where there are few professional offices.) Whenever I had to see a physician, it was usually an emergency walk-in clinic. If I got a script, there were no refills. On top of that, my health insurance company didn’t cover my asthma, claiming it was a “pre-existing condition,” despite previous insurance coverage. There was a note in my file, for whatever reason, and the only way to remove it would be to hunt down all my doctors back to childhood, and have them submit complete medical records to the insurance company. Not good.
This thread has been very helpful for me. I went to the doc the 24th and she said my lungs were clear but put me on Advair as well as renewing my scrip for Abluterol and Benzonatate to control the reflexive coughing when I need it. I hope to see some improvement soon.
I’ve got a prescription for the Advair as well. Last year my insurance didn’t cover it, so hopefully this year it will.