nymetsfan
08-13-2002, 12:47 PM
I was diagnosed with mild asthma, and given Atrovent to take if PFM went to 20% reduction. My PF drops to 500 at night and is usually 550 during the day. I have post nasal drip and coughing in the morning with clear flem mostly. I cough on and off throughout the day with throat tickle, but never feel short of breath. I know I get bronch-spasm in the middle of the night,sometimes because when I breath out it's kinda choppy, not smooth. But when I test the PF it's still 500. I wind up taking the Atrovent, just so I stop coughing and go back to sleep. The problem is, when I take the Atrovent it seems to make the symptoms worse the next day. Also I get skipped beats the next two days. Sometimes I wonder wether it's worth taking medication at all! This condition is very annoying.
Anyone else have these symptoms?
Anyone else have these symptoms?
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wrin
08-13-2002, 04:51 PM
If you are bronchospastic at night why are you not on some kind of maintenance medication? Does the coughing keep you from sleeping? Do you wake up in the middle of the night?
Atrovent is not usually the drug of choice for asthma -- it's more given to those with COPD, though it can be useful as it does not have as much of an effect on the heart like Ventolin does.
I have had symptoms like yours and found myself taking my inhaler a lot to keep my condition from irritating me and disturbing my sleep -- when I noticed I was taking it on a daily basis I went to my dr. about some kind of maintenance medication so I did not have to take it as much.
If the atrovent makes the coughing go away then it is likely the coughing is caused by bronchospasm. As much as atrovent lasts longer than ventolin does, talk to your doctor about going on something that lasts even longer than that, like Serevent (salmeterol) or Oxeze (formoterol). He might want to try you on either Advair or Symbicort which are both combinations of the long-acting bronchodilators (they last for twelve hours at a stretch) and a daily dose of corticosteroid that keeps the coughing from coming back on a more permanent basis.
These are taken twice daily (all four I mentioned) and for most people have worked extremely well to control even mildish asthma -- many people on this board are on advair, I am on symbicort. All I can say is it doesn't sound like your drugs are controlling you adequately if you have symptoms every day. (Your PF doesn't necessarily have to drop to dangerous levels before your condition becomes inadequately controlled.)
Atrovent is not usually the drug of choice for asthma -- it's more given to those with COPD, though it can be useful as it does not have as much of an effect on the heart like Ventolin does.
I have had symptoms like yours and found myself taking my inhaler a lot to keep my condition from irritating me and disturbing my sleep -- when I noticed I was taking it on a daily basis I went to my dr. about some kind of maintenance medication so I did not have to take it as much.
If the atrovent makes the coughing go away then it is likely the coughing is caused by bronchospasm. As much as atrovent lasts longer than ventolin does, talk to your doctor about going on something that lasts even longer than that, like Serevent (salmeterol) or Oxeze (formoterol). He might want to try you on either Advair or Symbicort which are both combinations of the long-acting bronchodilators (they last for twelve hours at a stretch) and a daily dose of corticosteroid that keeps the coughing from coming back on a more permanent basis.
These are taken twice daily (all four I mentioned) and for most people have worked extremely well to control even mildish asthma -- many people on this board are on advair, I am on symbicort. All I can say is it doesn't sound like your drugs are controlling you adequately if you have symptoms every day. (Your PF doesn't necessarily have to drop to dangerous levels before your condition becomes inadequately controlled.)
nymetsfan
08-13-2002, 05:35 PM
Thanks for all your info.
I will ask my doctor about the various medications you suggested. I have had albuterol before, and got shaky and hives. I am extremely sensitive to medication. That's why I have put up with the coughing, rather than dealing with the side effects of these drugs.
I usually sleep through the night, but I have flare up times when I awaken around 4-6am. If I get up and walk around the coughing stops. It's usually when lying down.
Thanks again.
I will ask my doctor about the various medications you suggested. I have had albuterol before, and got shaky and hives. I am extremely sensitive to medication. That's why I have put up with the coughing, rather than dealing with the side effects of these drugs.
I usually sleep through the night, but I have flare up times when I awaken around 4-6am. If I get up and walk around the coughing stops. It's usually when lying down.
Thanks again.
wrin
08-14-2002, 12:02 AM
there are other bronchodilators you can take that might not make you as shaky, berotec is one of them though I can see why you'd be on atrovent now...
Serevent and Oxeze can cause shakiness too, but because you're not bombarding your body with drugs as often it's more easily tolerated -- you also might want to ask your doc about xopenex, it's like albuterol except it's ... it's hard to describe, it's a different isomer of the regular albuterol, it's missing an inactive section of the molecule, and thusly works a little better.
Serevent and Oxeze can cause shakiness too, but because you're not bombarding your body with drugs as often it's more easily tolerated -- you also might want to ask your doc about xopenex, it's like albuterol except it's ... it's hard to describe, it's a different isomer of the regular albuterol, it's missing an inactive section of the molecule, and thusly works a little better.
ladybug_85
08-14-2002, 10:03 AM
I have your same problem!I am very sensitive to medication.I would not however recommend Foradil or Serevent( the long-acting bronchodilators mentioned).I had an awful reaction to Serevent as well as albuterol.
I have been able to use Xopenex,Unfortunatly its only available in nebulizer form so that can be a problem.Its also very expensive(although the price has gone down here).It comes in 3 strengths I believe.I love xopenex!According to everything I've read Xopenex actually lasts 6-8 hours VS Albuterol's 4-6 hours.
How about Maxair or Bricanyl?I also could tolerate Maxair very well.
I just want to state one more time I wouldn't reccomend Serevent or Foradil because from personal experience if albuterol causes you problems chances are Serevent and Foradil will too.
I have been able to use Xopenex,Unfortunatly its only available in nebulizer form so that can be a problem.Its also very expensive(although the price has gone down here).It comes in 3 strengths I believe.I love xopenex!According to everything I've read Xopenex actually lasts 6-8 hours VS Albuterol's 4-6 hours.
How about Maxair or Bricanyl?I also could tolerate Maxair very well.
I just want to state one more time I wouldn't reccomend Serevent or Foradil because from personal experience if albuterol causes you problems chances are Serevent and Foradil will too.
wrin
08-14-2002, 02:01 PM
xopenex and albuterol are almost the same drug, the original albuterol had two isomers, put together in the same drug. One was thought to be inactive, and one was thought to be the active drug, but they've found this supposedly 'inactive' compound can produce side effects, such as refractory bronchoconstriction (a side effect I've experienced on occasion)
Xopenex is simply only the active isomer -- it's more expensive because it's more difficult to make, and because it's only available in nebulizer solution, but it doesn't last longer. It may seem like it does because there is no refractory bronchoconstriction from it, so you don't notice when it quits working right away, but it is almost the same molecule and it's broken down the same way ... sorry to contradict, but I learned this at an inservice for respiratory therapists, which covered all kinds of new drugs, only one of them being xopenex.
The thing that sucks about most rescue meds is they only come in one strength -- except for the ventolin diskhaler, which comes in 100 and 200 per actuation, which doesn't really help (considering the aerosol is 100 per actuation anyway.)
Oxeze takes effect as quickly as ventolin does (though you can't just keep taking it because it DOES stay in your body for 12 hours and it WILL build up if you take lots of doses like you would take ventolin) and also comes in two strengths, the standard strength of 12ug which made me a little shaky and then the reduced strength of 6ug which I have found works almost as good and doesn't make me shaky at all.
The nice thing about taking nebulizer solutions like ventolin is that you can get them in bottle format (I think you could ask your doctor to prescribe the bottle instead of the nebules) and then dilute them yourself in sterile .45 normal saline. (Mostly just so they'll run well in the nebulizer -- dial out a proper dose with a 1cc syringe, say, half the normal dose, and then add an arbitrary amount of saline to increase the volume to 2.5 mL.)
I don't think Xopenex comes in bottles -- which sucks, because the bottles are a little cheaper. (You can get atrovent in bottles.)
It's a little more work but if you're sensitive enough to medication that a reduced dose would work wonderfully for you, it's a great alternative.
Xopenex is simply only the active isomer -- it's more expensive because it's more difficult to make, and because it's only available in nebulizer solution, but it doesn't last longer. It may seem like it does because there is no refractory bronchoconstriction from it, so you don't notice when it quits working right away, but it is almost the same molecule and it's broken down the same way ... sorry to contradict, but I learned this at an inservice for respiratory therapists, which covered all kinds of new drugs, only one of them being xopenex.
The thing that sucks about most rescue meds is they only come in one strength -- except for the ventolin diskhaler, which comes in 100 and 200 per actuation, which doesn't really help (considering the aerosol is 100 per actuation anyway.)
Oxeze takes effect as quickly as ventolin does (though you can't just keep taking it because it DOES stay in your body for 12 hours and it WILL build up if you take lots of doses like you would take ventolin) and also comes in two strengths, the standard strength of 12ug which made me a little shaky and then the reduced strength of 6ug which I have found works almost as good and doesn't make me shaky at all.
The nice thing about taking nebulizer solutions like ventolin is that you can get them in bottle format (I think you could ask your doctor to prescribe the bottle instead of the nebules) and then dilute them yourself in sterile .45 normal saline. (Mostly just so they'll run well in the nebulizer -- dial out a proper dose with a 1cc syringe, say, half the normal dose, and then add an arbitrary amount of saline to increase the volume to 2.5 mL.)
I don't think Xopenex comes in bottles -- which sucks, because the bottles are a little cheaper. (You can get atrovent in bottles.)
It's a little more work but if you're sensitive enough to medication that a reduced dose would work wonderfully for you, it's a great alternative.
nymetsfan
08-14-2002, 04:14 PM
You are all so well educated on medications!
I've gotten lots of good info. Since I only need a little bit of meds to work, I usually take half a puff of my Atrovent and it works within 5 minutes, and lasts 6 hours at least in my system. When it wears off I can tell because my lungs feel irritated for a while, like my symptoms are exacerbated. (spelling?)
This is a rough allergy season this year. It really started with 9/11. We had so much smoke, and it smelled like burning wires for many days. My husband and I run every morning, and I think we made the mistake of being out there exercising in the air that following week. I've never had so many nose bleeds and sinus infections as I have had this year.
I've gotten lots of good info. Since I only need a little bit of meds to work, I usually take half a puff of my Atrovent and it works within 5 minutes, and lasts 6 hours at least in my system. When it wears off I can tell because my lungs feel irritated for a while, like my symptoms are exacerbated. (spelling?)
This is a rough allergy season this year. It really started with 9/11. We had so much smoke, and it smelled like burning wires for many days. My husband and I run every morning, and I think we made the mistake of being out there exercising in the air that following week. I've never had so many nose bleeds and sinus infections as I have had this year.