im just wondering in other peoples experience what is the next stage i can have in meds really.
i am on currently seretide 125, salamol 100, cetrazine and nasofen aqueous
I have been told my 2 inhalers are not working for me and i need them changing when i see the asthma nurse but im not sure what else they can give me as i was very mild untill recently
There is plenty more you can try, higher dose of seretide 250 or even 500, montelukast or zafirlukast tablets. Look up the British thoracic guidelines brit-thoracic.org.uk/clinic... The stepwise management in adults table is useful as a quick glance summary
Thank you
I as i have no idea what is available for me i get stuck, and im just in the middle of changing gps as well as my old ones didnt know or help me much with my asthma i have no idea where i am or anything
Good luck with new GP practice. Ask for an action plan if you've haven't got one-they're available on this website, look along the top under all about asthma and then publications at the bottom. As I said before, there is lots of options. You could have the Seretide increased, add in montelukast (one tablet a day)... Have copied this from the BNF (British National Formulary) for you, bnf.org/bnf/bnf/current/119...
Adult and Child over 5 years
Step 1: occasional relief bronchodilator
Inhaled short-acting beta2 agonist as required (up to once daily)
Note Move to step 2 if needed more than twice a week, or if night-time symptoms more than once a week, or if exacerbation in the last 2 years
Step 2: regular inhaled preventer therapy
Inhaled short-acting beta2 agonist as required
plus
Regular standard-dose(1) inhaled corticosteroid (alternatives(2) are considerably less effective)
In adults 6-week sequential therapeutic trial of one or more of
Leukotriene receptor antagonist
Modified-release oral theophylline
Modified-release oral beta2 agonist
Step 5: regular corticosteroid tablets
Refer to a respiratory specialist
Inhaled short-acting beta2 agonist as required
with
Regular high-dose(3) inhaled corticosteroid
and
One or more long-acting bronchodilators (see step 4)
plus
Regular prednisolone tablets (as single daily dose)
Note In addition to regular prednisolone, continue high-dose inhaled corticosteroid (in exceptional cases may exceed licensed doses); these patients should normally be referred to an asthma clinic
Stepping down
Review treatment every 3 months; if control achieved, stepwise reduction may be possible; reduce dose of inhaled corticosteroid slowly (consider reduction every 3 months, decreasing dose by up to 50% each time)
(1)Standard-dose inhaled corticosteroids
Beclometasone dipropionate or budesonide 100–400 micrograms twice daily; child under 12 years 100–200 micrograms twice daily
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