SABA 2p BD

Im a practice nurse, Ive recently advised a patient they do not have to use their SABA bd before their ICS, however they have just seen the GP who are still insistant this should be done. Is there any literature about regarding this?

[yaf_user681_32991]

Hi Mandy Lou

Could you put that into ""English"" for those of us that aren't completely familiar with medical--eze please :O)

Welcome to the group btw

Geina x

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Sorry, ICS -inhaled corticosteriod (brown inhaler)

SABA - Short acting beta atagonist (Blue)

This is what we usually use when typing up records for short.

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Not sure about literature. But I have been advised by several GPs to take the blue first. Welcome to forum too

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I always use ventolin before my steroid inhalers - makes them much more effective in my opinion. Not sure about any research.

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I used to be on the brown inhaler and was advised to take 2 puffs of blue first, now have the same advice with Seretide (purple). My GP advised that as the blue is fast acting it opens the airways to receive more of the steroid when you take it, giving you more chance to absorb more of the preventer drug. I thought it was standard practice, but sorry don't know of any literature about it.

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Dear Mandy

Interesting question and responses. i dont take my bricanyl before my seretide and havent been advised to by GP or Nurse. however i have heard from others (including my father - retired GP) that the releiver inhaler is better absorbed if the airways are open ie by taking the blue one 5 mins or so beforehand. Can i suggest that you could check the British Thoracic Society website

brit-thoracic.org.uk/guidel..., which might provide some protocols on the use of inhalers.

Take care xx ><>

[angievere]

Hi Mandy, Welcome to the forum. Me and my son have been advised to take ventolin before preventer inhaler - must admit I dont tend to do it, but my son (14) does if he's going through a bad patch.

[yaf_user681_32991]

:O) as it happend I knew most of it- jsut the ICS that threw me.

I never got advised to take my releiver before preventer but then again, i was left to do my own research etc.

G x

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Not seen any literature on it for long time. I'm sure it was on one of our advice booklets . We recommended blue to open the aIrways so. Higher proportion of steroids could then reach the lungs when used Later....

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Mandyloub, you may find more appropriate answers in the health professionals section?

Don't think I have ever been told this and have moved several times.

Maybe worth try doing a literature search if only Google Scholar as a starting point?

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I was thinking that with the newer inhalers e.g. alvesco and spririva resmat these have smaller particles in each of the sprays and are proven to get deeper into the lungs to get to the small airways. With these inhalers there is no need to take the ventollin beforehand.

[yaf_user681_30355]

This is an interesting topic. When I was first put on a steroid inhaler in 1988, the instructions back then were to use 2 puffs of your reliever 15 minutes before your steroid inhaler and if you needed your reliever as and when to use 2 puffs each time. As the knowledge grew, (I'm not sure when) the instructions changed to only take 1 puff of reliever at a time and only when symptoms arise. I am the same as your son angievere, I have always over the years taken it before my steroid inhaler when my asthma was playing up.

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Theoretically, if asthma is uncontrolled, then I suppose taking SABA 15-20mins before using ICS might do as has been proposed below. However, as a routine thing for controlled asthma, I couldn't see a role for that practice - but that is just me theorising. For literature, you might be better looking at the full version of the BTS Asthma Guidelines, there may very well be comment/reference about it in there.