New to asthma need answers quick about meds inhalers & steriods!

t_panic411 · 06-22-2006, 04:35 PM

Hi, i was just diagnosed about a week ago with reactive asthma. I stopped smoking but what brought mine on was long term exposure to bleach in my bathroom.
I'm 31 and never had any asthma before this so it's all new to me.
I had some trouble the 1st 3 days keeping it under control because I didn't know how so I was in ER and urgent care off and on those 3 days.

They have me on levalbuteral .63mg for nebulizer (i weigh 104 pounds but they said i could double up on that dose if I needed to), also had a steriod shot plus they gave me a steriod inhaler to use 2x daily called Qvar 80mcg.
I've been doing the xoponex (spelling?) levalbuterol every 6 to 8 hours and the steriod every 12hrs.

I rinse and gargle my mouth clean after with water a few times but my throat is getting kind of raw/horse feeling. I've been drinking warm tea w/honey to try and help with the dry throat feeling but it's not working.

For a couple of days I felt pretty good, had it under control but last night and today I have been feeling tight in my chest as if i need the levalbuterol sooner than 6 hours. I also have an albuterol inhaler as back up but I haven't used it since I got the levalbuterol/nebulizer.

Albuterol makes me VERY shaky and feel like anxiety which doesn't help my breathing... It also seems to take up to an hour to open my airways which the levelbuterol was working almost right away to open my airways. Now today and last night it has not been helping so quickly.

I can breathe right now but I'm having to work a little hard at it cause of the tightness and raw/dry feeling (i guess?).

NOW, my question is:
Which meds are best to open the airways w/o too much jittery feeling and w/o making your airway opening feel raw/dry?
Also, which steriod inhaler seems to work best for you? I'm on Qvar, have any of you tried it before? Did it do the job or is there something better?

feel so tight in my chest right now, I can't get comfortable and I just had about 94.5mg of xopenex levalbuterol which is 1 - 1/2 of the tubes of med. this was about40 minutes ago so, what gives? Why am I not opening up now?
I'm pretty scared and don't wanna end up in the ER again tonight. I have to get this right cause I have to go on a flight tomorrow.
HELP!!!!
Thanks!!!!

t_panic411 · 06-22-2006, 07:29 PM

Well, I just went to the urgent care for not being able to get a good breath...
They said I might be getting a yeast infection in my throat. Yippy, as if it couldn't get any worse. So, they gave me 3 fluconazole 150mg tablets to take over the next few days. He said it probably wont help with my breathing but it will help with horseness/dry airway throat feeling. He also gave me bidex which is like mucinex to try to get any mucus out of me. I don't really feel i have too much mucus cause everything is so dried out I feel like a human raisin.. I guess I could be wrong, who knows at this point. He said for me to rinse my mouth with 50% hydrogen peroxide/50% water after using my inhalers to help protect me from oral trush. I did notice that after about 30 minutes of being out of my house I was starting to breathe a little better slowly so maybe it's just something in our house. I have a dog indoors, our house is not that old haso i shouldn't ve mold iI to just camp out in the yard for the ssues, but we for sure have huge dust issues. This sux. Am rest of my life or what?

dazedandconfused10 · 06-22-2006, 11:50 PM

Wow I wish I knew more about all the meds but yes , rinsing after using steroid inhalers is a must, I rinse and brush but perhaps you are more sensitive.
I have albuterol and have not used it much. Luckily I have not gotten jittery. It did take about an hour for 2 puffs to really work so there probably is some absorption time with any med. I also use advair for preventative, are any of yours supposed to prevent an attack?
Less humid air is better for me and if you have a pet that could be a complication. I went on a cleaning rampage against dust , the house was cleaner but I can't say I saw much difference. But everyone is different.
Do you have one dr managing all these meds?

t_panic411 · 06-23-2006, 09:30 AM

Yes, I have a Dr who I have seen 3 times for this except for the one at the ER. The Qvar is the inhaled steroid and is supposed to be my prevention.

Levalbuterol in nebulizer is my 4 to 6 hour rescue. Albuterol is my rescue inhaler to take with me when out of the house (can only take a puff if it's close to the time for the levalbuterol to wear off.)

Now, the mucinex I took a load of like he said to last night and today and I coughing up a little mucus. I took one of the fluconazole tablets lastnight too for a trush/yeast infection he thinks I have in my throat and chest and today I don't feel the scratchy/dry/horse feeling in my airway opening.

After I got out of the house and sat in the Dr's office for a while my breathing did get a little better so it for sure has to be something in this house that is triggering my attacks. It seems worse some days than others so, I have no idea what it is.

I went on a cleaning rampage too (had to wear an allergy mask) and got rid of all the dust, dog hair, etc that I could find. The dust just keeps coming back pretty thick every 3 days and so does the dog hair (it's shedding season for him)! So, we for sure have a dust and dog hair issue.

I just want to be able to have more good days with this than bad and I don't understand WHY one day albuterol or xoponex(levalbuterol) DON'T seem to work as my rescue and other days it works fine. It scared me to death. I couldn't catch a good breath all day yesterday from about 7AM to about 6pm! That's WAY too long...
I was so scared, ended up crying (that could be the steriod injection making me moody) but heck! This stuff is just plain old scary so who knows... Right now I can breathe ok but I just got up so we'll see after I start stirring around the house. PLEASE GOD LET IT BE A GOOD DAY!!!!

KWSN · 06-24-2006, 03:04 PM

t_panic411-

Like you, I developed asthma as an adult (35 y.o. in my case) and it sucks, and I'm wondering whether I am doomed to be always worrying about my breathing for the rest of my life. But, the right combination of meds can make a significant difference. I think your situation can be improved by seeing an asthma specialist to get your meds straightened out and a comprehensive treatment plan based on monitoring your peak flow put in place.

You can get levalbuterol (Xopenex) in a standard inhaler now. I carry one around everwhere that I go. For me, the levalbuterol causes MUCH less shakiness than albuterol. The reason for this is that albuterol is actually a mixture of two compounds: levalbuterol and its enantiomer (dexalbuterol). Roughly speaking, levalbuterol is responsible for the good effects (relaxing smooth muscle in the lung and allowing you to breathe more easily) and dexalbuterol causes the side effects (shakiness, elevated heart rate, etc.).

I think you need to give the Qvar more time to work. It took at least two weeks for the inhaled steroid to really damp down the inflammation in my lungs. The effects of inhaled corticosteroids come on so slowly it is hard to notice day-by-day. However, after a couple of weeks you will feel better. I haven't had any problems with yeast infections, but I rinse thoroughly and brush my teeth after inhaling.

I'm no medical doctor, but I think your meds aren't right. You are nebulizing levalbuterol as a "daily control" med, but essentially using the same med (albuterol) for your "rescue" medication. There is only so much good that you can get out of a short-acting beta-agonist like albuterol.

The more standard combination is a "long acting" beta agonist like salmeterol as the "daily control" med and albuterol or Xopenex as the "rescue". This is in addition to a corticosteroid (like Qvar, Pulmicort, Asmanex) taken for long term control. Many people are on Advair which is a mixture of salmeterol and a steroid in one inhaler. Beta agonists and corticosteroids can work together, so the combination is more effective than either drug alone.

Like I said before, I think you need to see an asthma specialist to get your meds straightened out and put together a comprehensive treatment plan.

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