Anyone else's allergic/asthmatic child just not respond to salbutamol?

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Dd (6) is anaphylactic to dairy, also avoids egg, sesame and nuts. Her asthma is generally well controlled, in fact she is 100% well in terms of asthma most of the time but when she isn't there seems to be nothing (apart from short course of oral steroids) that makes it better. I know that salbutamol isn't helping and she says herself she thinks it does nothing. When she was little she had one bad attack when they gave her back to beack or hourly salbutamol for 3 days. It was only when they added atrovent (every 3 doses)that her oxygen saturations went up.

I read some research last year that said there are some children (with a specific gene) for whom this drug doesn't work but no one at our hospital will listen to me (understandably they are worried I will ditch the standard treatment and cause her harm).

But I feel vulnerable that we have no drug apart from steroids that makes her better. It would be a great help if anyone has experienced similar.

There is a new study being done on a magnesium based inhaler, DS2 took part in a trial when hospitalised for three days earlier this year with his first ever without warning asthma attack.

I presume you have seen a consultant, but have you seen a specialist, even if you hgave to pay privately?

Has she had the pink medidine, prednelasone, or something too, taken orally?

Is is the brown one salbutamol? It does take a while to work 6-8 weeks I think.

Have you child any asthma support groups online for advice?

Thanks carocaro. That is interesting about the trial.

Salbutamol is the blue reliever which is supposed to give pretty rapid relief. It just never seems to do that for us. Re steroids: yes, it is the pink prednisolone that I mean. She hasn't had it loads of times but obviously it would be better if we didn't get to that stage at all.

How does she take it?
Is it direct from the puffer - if so she might not be capable of taking it down, it could all be landing on her throat or tongue.

If she has a spacer, it ensures she breathes it into her lungs so it actually does some good.

One of <a class="break-all" href="http://www.google.co.uk/imgres?imgurl=www.ambulancesforasthma.net.au/images/spacer.jpg&imgrefurl=www.ambulancesforasthma.net.au/act/meds.html&usg=GN-7i2ThY9f96FelhViajKQCmAA=&h=225&w=300&sz=7&hl=en&start=0&sig2=smcpheK4JPqXd3KkIaFANA&zoom=1&tbnid=eKeapBsaKB7QBM:&tbnh=147&tbnw=188&ei=nFoKTe-DJOFhQfCtOSGDw&prev=/images%3Fq%3Dspacer%2Bfor%2Bventolin%26um%3D1%26hl%3Den%26sa%3DN%26biw%3D1659%26bih%3D844%26tbs%3Disch:1&um=1&itbs=1&iact=rc&dur=172&oei=nFoKTe-DJOFhQfCtOSGDw&esq=1&page=1&ndsp=35&ved=1t:429,r:0,s:0&tx=102&ty=90these" rel="nofollow" target="_blank">www.google.co.uk/imgres?imgurl=www.ambulancesforasthma.net.au/images/spacer.jpg&imgrefurl=www.ambulancesforasthma.net.au/act/meds.html&usg=GN-7i2ThY9f96FelhViajKQCmAA=&h=225&w=300&sz=7&hl=en&start=0&sig2=smcpheK4JPqXd3KkIaFANA&zoom=1&tbnid=eKeapBsaKB7QBM:&tbnh=147&tbnw=188&ei=nFoKTe-DJOFhQfCtOSGDw&prev=/images%3Fq%3Dspacer%2Bfor%2Bventolin%26um%3D1%26hl%3Den%26sa%3DN%26biw%3D1659%26bih%3D844%26tbs%3Disch:1&um=1&itbs=1&iact=rc&dur=172&oei=nFoKTe-DJOFhQfCtOSGDw&esq=1&page=1&ndsp=35&ved=1t:429,r:0,s:0&tx=102&ty=90these

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Ds2 was allergic to salbutamol. He did very well on Atrovent and pulmicort.

He also coped much better when his pulmicort was substantially increased - he needed 2 puffs 4 times daily. When he had enough preventer, he needed his reliever far less.

Once I got the hang of increasing his preventer at the first signs of trouble, I kept him out of hospital.

IMO many people under use the preventer inhaler.

Thanks all. Catinthehat - yes she has a spacer so I don't think it is that and pixie - however big the dose, it just doesn't seem to do much. Or it seems to at first but then her response gets less and less - and that isn't just the asthma escalating, I am sure it is to do with the drugs.

3littlefrogs - can I ask, how did you know he was allergic to salbutamol? I have wondered that myself. And how does he take his atrovent - we have only had that via nebuliser. Is there an inhaler too?

He just used to get much worse on the salbutamol, coupled with a very fast heart rate. It actually made him very distressed. My GP said this was quite common - salbutamol is quite an old fashioned drug and really doesn't suit everyone. There are lots of different relievers and it is well worth trying a few.

My GP was lovely though - he tried him on quite a few different things. Yes - there is an atrovent inhaler, and we used it with the spacer device. Ds was able to use it from the age of about 2, with the spacer.

He is 19 now, and has outgrown his asthma. He just keeps an inhaler around "just in case", but hasn't needed it for ages.

I have re-read your post and your DD sounds exactly like my ds.

How long has she had asthma?
Is it allergic asthma?
Is it made worse by a cold?

Ds developed his asthma as a result of RSV at 4 months. He was really, really ill and suffered very badly for about 10 years afterwards.

That is really good to hear 3littlefrogs - both that there are alternatives and that he has outgrown it. I have been treated as if asserting the world is flat or something - just not possible that salbutamol doesn't help, must be the way we use it...

She has had asthma since about 1.5ish and yes it does seem to be allergic. Back to back colds plus another trigger (eg animal hair/mould) seems to be the pattern for a bad attack. She has had colds without any wheeze at all but once she has started wheezing there seems to be no way back without oral steroids.

I wonder if she is allergic to salbutamol too. She coughs more and more when given it, as if it irritates her airways. I have always been told this is the airways responding and opening up .

Has she been seen by a paediatric asthma specialist - ie not just the GP. (No disrespect to GPs, but clearly a specialist opinion is needed here)?

Also - do you use a preventer inhaler all the time? Using a reliever inhaler on its own is not sufficient - the preventer is so important, and should be used consistantly, even when the child is well.

What about antihistamines?

Yes we are seen by paediatric allergic/asthma specialist but I'm not convinced she is that good tbh. And we do use a preventer every day, religiously which seems to keep things at bay most of the time.

I have now put my point more forcefully (!) to the asthma nurse at our hospital and are being seen today for a medication review. Hope to get some answers - thank you all for reassuring me that I am not just bonkers!

with DS, he used to have 2 puffs of his preventer twice a day, but at the first sign of a cold, that went up to 2 puffs 4 times a day until the cold was better. (My GP told me I could increase it further if necessary, but to phone him to discuss). We also used the Atrovent regularly if ds had a cold - it seemed to keep things under control.

Thanks 3littlefrogs, for some reason they no longer advise upping the preventer once they are wheezy (I suppose because it takes too long to act) but we are on her higher dose now anyway. Hoping that and the atrovent sorts things. I have been dreaming of a 19 year old version of dd asthma and maybe even allergy free....