asthma question ....

[hazeyjane]

Ds has recurrent lung problems and has recently been diagnosed with asthma.

He has had a chesty cough for months, no infection, but keeping him up at night. Gp last week said his lungs sounded full of inflammation, but his O2 levels were at 96. He told us to double his Clenil (to 4 puffs am and pm). A week later and he is still needing several puffs of blue inhaler daily - 6 yesterday, 4 today (given at school) and is still coughing well.

Should it have improved by now?

I have always been told that doubling up Preventer Inahler isn't advised anymore as it takes so long for the doubling to take effect (or so 2 respiratory consultants have told me)

If he is struggling I would take him back as he may need steroids.

Thankyou Sirzy.

Dd2 has asthma but has been well controlled (so far) with serevent and clenil - so she hasn't needed prednisalone for a long time.

The gp said it should take a week to kick in , which on the one hand sounded a bit quick and on the other sounded like a long time if he is struggling (IYSWIM.)

Sat up with him now, cough cough coughing. Ugh I hate lungs.

Take him back to Drs or ask to see asthma nurse if you have one at ur GPs. I've never had to double up on preventer. Although DS now has 200 dosage as he keeps needing steroids

Also DS is allowed 8-10puffs of blue inhaler at one time with a count to 8 during each puff using spacer.

Doubling isn't recommended for managing exacerbations or episodes of illness, but can be used in initial dosing to find an optimum regimen.

For example if he's on Clenil 50, you'd normally give 2 puffs twice daily ie 200 mcg total each day. But if he's no better you'd go up to 400mcg daily ie 4 puffs twice daily, and then review, then increase to 800 mcg if needed. You want to get on top of the inflammation but this can take a good 2-3 weeks; obviously if he's worse or his oxygen levels drop you'd take him back and they may give oral steroids (prednisolone).

I'd give it another week or two (depending how he is of course - if he's improving, great, if deteriorating, go back) and give him his salbutamol (ventolin - blue inhaler) every 4 hours, 2 puffs (one at a time but in pairs) up to 10 puffs, through a large volume spacer. If he's still needing 8-10 puffs every 4 hours to stop the coughing then see someone sooner, OOH if necessary.

Hope he's better soon