I recently had my second very nasty asthma attack in six weeks. I could feel it coming but neither gp nor hospital team nor later 111 would ring back or talk to me as my readings deteriorated.
So I had my attack at 2 in the morning on sunday, and 999 sent out paramedic with nebulisers which stopped it luckily. As ambulance system in chaos.
The Monday after gp gave me prednisone and the change in long term asthma meds the hospital had been advising for last two weeks..... Montelukast and fostair 200.
I asked my gp if I could have anything to stop nasty attacks. The answer was, no, as they did not give out emergency asthma medication as their approach was that you should talk to a gp if in trouble.
Thoughts..... Is it normal to have emergency prednisone.
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Homely2
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My GP won’t give emergency packs. As for talking to your GP 😂😂
My peak flows started dropping. Saw GP. Listened to my chest. Looked up my predicted scores. Advice - keep pushing the blue inhaler. Readings continued to fall. Saw same GP - I seem to remember we had a long conversation about your peak flows last time. Listened to chest. No, you don’t need any antibiotics or prednisone. Then, as I walked out he said, “ Don’t worry. When you have an attack, which you most certainly will, I will prescribe for you.”
And yes. I did have an attack. Two as it happens. And yes he did prescribe for me. Better than not at all I suppose.
They seem quite paranoid on prednisone. When they prescribed the prednisone to me, five days, eight tablets a day, so 40 in total. The prednisone came in packets of 26, so two packets came, so 52 tablets, but they had literally gone into the packets and removed 12 tablets.
But the approach does differ from doctor to doctor, with some seeing the benefits of early treatment in order to prevent hospitalisation. Unfortunately, it's not something we can expect and the trick is to establish what your GP is willing to do in order to get you fast treatment.
My GP surgery is quite often happy to prescribe over the phone when talking with someone who has seen me in the past and knows my case, referring to past treatment and consultant's advice. However, last week I was asked to pop in to see the nurse practitioner as she didn't know me or my case and she was very thorough. She prescribed antibiotics but was reluctant for me to start my emergency Pred, which I thought was very different to what my GP would have said. She was firmly in the Ventolin corner, which is not something my asthma nurse is for, but I wasn't going to debate it. I told her I would continue to follow my asthma plan and she thought that was sensible.
But if my GP surgery was awkward about same day appointments when necessary, I would be looking to change. I'm fortunate that my surgery have a facility for cases that require same day assessment, even if it's a telephone appointment. I would feel less than supported though if their default position was for me to rely on A&E or expect me to worsen until I had an asthma attack before they would escalate treatment. What are asthma plans for if a GP is going to withhold treatment until an attack happens? They wouldn't be dong that to me twice.
It does seem to very from GP to GP. It's only in the last 10 years or so that I have had a week's course of prednisone added to my repeat prescription list. If you are prescribed 8 tablets daily for 5 days then that is what the pharmacist should give you, not more or less.
Presidone is only given if you have a chest infection and your breathing is difficult. Usually given after a visit to your GP. If you were in hospital they woukd usually give you sterouds intravenously cos they work quicker. I have suffered asthma for over 60 years. I have a nebuliser at home but rareky have to use it. You may be able to get your GP to order one for you. They are very good if you feel an asthmatic attack coming on, it saves goung to hodpital. Hope this helps
I have a number of chest problems. My GP and Consultant recomend that I have emergency Preds and Antibioltics for emergency use. Possibly this is due to my difficult to treat asthma etc. If I have any problems at all with my chest I must be scene in A&E as an emergency case. I have been told by all the medics who have dealt with me to use 999 and get to A&E So with hope that this remark does not upset anyone but Asthma is not something to brush under the carpet like some GPsEtc.do it it can be life threatening as I have persobnaly reached this stage, so call 999 in my opinion if you are realy struggling to breath at least let the paramedics see you and do all their routing stuff
Hope that you all have a Merry Christmas and a very Health New Year
Emergency pred is part of my treatment plan when my asthma worsens even when I up my ventolin. Not sure if that's true for everyone, just sharing my experience. How are you feeling now?
My only step up position is to take oral steroids, so I always have emergency packs on hand and my G/P is happy to prescribe, I also have emergency anti-biotics, but my refills for that have to come through the consultant as they are a bit unusual, and he wants to know immediately, if only by email when I have an episode. and when I have used prednisolone and/ or Anti-biotics. I tend to get told off for not going on prednisolone sooner. But sometimes its hard to gauge as I can have a bad day, and then be much better the next. I usually wait and have 3 or 4 bad days of numbers before reaching for prednisolone.
I guess if you can always get hold of your surgery its okay, And I actually think its quite important that the doctors know exactly what you are taking when. Oral prednisolone is wonderful, but has terrible long-term side effects if you are constantly using it.
I would say that if you are using your blue inhaler more than 3 times a week. (except pre-exercise and or have a cold/ infection). Then your asthma is not controlled and you should see your doctor to change your day to day medication.
I was in the same position, usually have an asthma attack at weekends when very difficult to see the GP. Once spent three weeks trying daily to see GP phoning everyday and couldn't get an appointment when I eventually did manage to get one GP said why hadn't I seen him earlier!needed a nebuliser at the surgery..After being referred to a consultant he immediately recommended that I have a rescue pack of antibiotics and steroids to take when required on repeat prescription.
I am however aware of the side effects of pred regarding joints teeth and stomach issues.
an interesting point was raised by an Oxford based consultant during a BLF and Asthma UK conversation/ they do not prescribe salbutamol at all but now recommend a combination inhaler Symbicort which latest research shows to be more effective- you can increase it as needed in line with peak flow score etc
Interesting discussion. I've had emergency antibiotics and pred for the last 20+ years - pre covid I travelled overseas for short work trips and sometimes needed them. Since covid times my GP won't prescribe them. Which worries me now I'm travelling again. Consultant said he'd prescribe them but it's up to GP.
In my (non medical) opinion it's trends influenced by covid times.
I have always been told to keep a course of steroids at home in case of emergency. They came in very handy over the Christmas period as I developed this flue bug thats going about and my asthma went haywire. I was using my ventolin at least 8 times a day and also increased my symbicort on the advice of the pharmacist but nothing helped so I am now taking my emergency steroids. I can only go by the advice I was given and I must admit it works for me. Good luck and keep well .
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