Bad spell of asthma

[Angel1981]

My partner has had asthma all his life but has been well controlled as an adult. Since January he has suddenly had problems. He was taking salbutamol & lowest dose seretide. He has now been increased to Seretide 500 & given atrovent inhaler & a nebuliser. How often should he be using the atrovent nebules rather than the inhaler? It just arrived but he wasn’t given much guidance on how often. (Got a few days before next appointment). Is it likely that his asthma will become well controlled again or could this be the beginning of it worsening permanently?

[hilary39]

I’ve also been in a the worst flare of my life since January. It’s hard and scary. If he is more aggressive about his treatment he will hopefully see an improvement. A few thoughts:

1) could there be any new triggers in your life? Pets dust pollen smoke mold etc that are new since January?

2) do you vacuum often and use air purifiers with hepa filters? Indoor air quality is important to control as best you can for asthmatics-

3) has he taken prednisone? If his asthma is uncontrolled even with regular steroid bursts, doctors recommend starting a biologic treatment such as xolair or nucala. I have allergic asthma so I just started xolair (it targets igE to prevent histamine and mast cells from being released). Nucala lowers the number of eosinophils which reduces inflammation. He should get a blood test to measure both to see if one or the other is a better fit. They are lifelong drugs and you have to get injections once or twice a month depending on your situation but they are miracle drugs for some people.

I’ll leave the nebulizer question for other people to answer. I know my doctor has me use mine once a day during particularly bad flares but I have diff meds than Atrovent-

Good luck, I know it’s so hard to see someone you love suffering. My husband has often felt helpless during these last difficult six months.

Take good care-

[Hidden]

Take neb up to 4 times in 24 hours until you check with your go for your plan

[Tugun]

Hi Angel,

Firstly one good thing is that a flare up of asthma does NOT mean that it is permanent - no matter how long it takes to get better. Also looking at the information below on the differences between salbutomol (ventolin) and atrovent sounds like he may need to go back on the salbutomol. Are the nebules atrovent nebules or salbutomol/ventolin nebules?

A flare up that quickly is unusual without a trigger. Is he able to work out what that trigger was? Food? Chemical inhalation? Mould? Pet? Chest infection?

The below is taken straight from healthcentral.com/article/w...

"The thing about Ventolin, as I'm sure you know, is it gives you immediate relief you can feel, and that's why it's called a rescue medicine. Atrovent can open your airways too, but its effects are generally mild and may take longer than Ventolin. While Atrovent is generally not recommended by the asthma guidelines as a frontline medicine for most asthmatics, it has proven beneficial for some. So you should try it and see if it works for you. But Keep your Ventolin on hand just in case you need it.

Here's some information about Ventolin and Atrovent:

Ventolin is a beta adrenergic medicine. It is a medicine that attaches to beta 2 receptors that are on the muscles that surround the air passages in your lungs (bronchioles) and cause the air passages to relax. It can rapidly open up your lungs making it easier to breathe. It is considered a front line medicine for treating acute asthma symptoms.

Atrovent is an anticholinergic medicine. Our bodies release a natural neurotransmitter (Acetylcholine) that attaches to cholinergic receptors in the muscles surrounding the air passages in our lungs. This cause these muscles to spasm, and your air passages to become narrow (bronchoconstriction). Thus, Atrovent particles attach to these cholinergic receptor sites and block the cholinergic response, thus prevening this airway narrowing. To control asthma, usually there are better medicines than this. However, when all else fails, this is a good option to try. Most experts call Atrovent a back door bronchodilator."