Mart asthma plan

[elanaoali]

I used fostair 100/6 for my mart asthma plan. In the spring/summer I take one puff twice a day and in the autumn/winter I take two puffs twice a day. My plan says a maximum of 8 in a day. So at the moment that would leave me 4 puffs if I had an asthma attack. So if I needed more than 4 in an attack would that be okay?

[Phoenix1992]

That is something to ask your asthma nurse. Do you have an action plan? There is a template of an action plan on the ALUK site, may be worth having a look at that and filling it in with your asthma nurse. It also explains what to do if you have an asthma attack.

I am on Symbicort MART but also have a salbutamol inhaler with a spacer as I can either reach the max and need more, or have a more severe period of shortness of breath and be unable to breathe deeply enough to use the powder Symbicort. I am also prescribed up to 12 puffs as this happens every summer. So for example, this year, I had an infection in February and I needed oral steroids. Then, I reacted strongly to the pollens in July and we had a more humid summer, so was on 12 puffs and some salbutamol at times. I was stuck on the sofa alot, but after 5 days, the 12 puffs calmed things down and I didn't need steroids. It came very close. So, the MART action plan is tweaked for me. I don't believe there is a 200/6 pressurised inhaler, only a 100/6, something I need to discuss with my asthma nurse as that would help my situation.

Unfortunately, I wasn't well enough with my mental health to see her in the summer and my appt was cancelled last month due to staff sickness, so haven't had that conversation.

Usually, it is if you need your maximum puffs regularly, make an appointment with your asthma nurse to review your medication. If reaching 8 puffs and you are still really struggling, ring 111/999 depending on the severity. I have never been on Fostair so I don't know the maximum that is still safe. It probably says it in the leaflet, it's just having that discussion with your asthma nurse to get the OK.

I always like to know the 2 steps ahead of what is the maximum I can step up, when I am having an exacerbation and when to seek advice.

I hope this all helps.

[Poobah]

Usually, asthma plans set a limit on a rescue doseage when having an asthma attack and then instruct the patient to telephone 999 if that action hasn't controlled the attack. 8 inhalations of a long acting bronchodilator is a high dose and if you're still short of breath, it means you require urgent medical treatment.

It's best to know what action your asthma team expect you to take once you've reached the maximum dose, but if that's unavailable and you've already had 8 doses and still struggling, dial 999.

If you're having to rely on high doses every day for a period of time, it's an indication that you require additional treatment and should seek a same day appointment with your GP.

[Troilus]

Not sure on that one, but you can still use your blue inhaler.

[elanaoali in reply to Troilus]

I don't have a blue any more as I was put on mart regime. You use your mart inhaler as a reliever. I use my inhaler (fostair 100/6) as combination and reliever.

[peege in reply to elanaoali]

I used an old Ventolin last year when I had a really bad infection in Jan '23 then another not so bad in June '23. I've a couple of newish Salamol in 'stock' as well although last time I ordered it I had a texts saying "well give it to you this time but you shouldn't need it at all". Grrr. In my opinion 95% of the time the Fostair MART is perfect but when ill 18 months ago Fostair most certainly wasn't enough so like you, what are we supposed without the occasional rescue. A call to the helpline would be helpful for guidance I think. 0300 222 5800, let me know what they say.

[Troilus in reply to elanaoali]

I’m on mart but still have open prescription for the blue inhaler

[ReedB]

Hi, I'm also on the Fostair 100/6 mart and can take an extra 6 puffs (on top of the max 8) if I'm having an attack BUT I was told by my asthma nurse/plan that I should be calling an ambulance at the same time or be heading to A&E.

[elanaoali in reply to ReedB]

I am a little confused about what you have said. How can you take an extra 6 puffs on top of your 8. My asthma plan says a maximum of 8 in total including my regular doses 2 in morning and 2 at night. And if this doesn't settle my asthma symptoms go to A&E. I did that recently because I came down with covid and this set off 2 asthma attacks in 3 days. The first attack I did the 4 puffs and that settle it but 1hr later symptoms returned. So another 4 puffs it didnt work so A&E and started my rescue steriods. I didn't call an ambulance as the nhs are too busy and the wait would be too long. So I get my husband to take me A &E (5 mins by car). Please don't lecture me.

When I saw the doctor I had a small wheeze but hard to detect.

So I was fine.

2 extra days of steriods on top of my usual 5.

I think I am going to ring and make an appointment with my asthma nurse. Thank you every one for your advise.

[Homely2 Administrator]

I asked my GP asthma nurse this question, she said in an emergency I can take another six doses, and ring 999 if it does not work. I should then go and see an asthma nurse the next day.

You need to ask your asthma nurse for advice particular to you, as we are all different.

[elanaoali]

Hi all sorry for not replying to all your lovely replies. Ask for an appointment with asthma nurse from my surgery last week. Had a telephone appointment with a GP. Ask about my inhalers and the mart regime. This is what I was told. If you use more than 4 puffs extra in day due to flare up call for appointment asap. Tell me you have emergency steriods and ask if you can taje them. I use to take the 1st dose and then contact my GP.

If you are having an asthma attack use 4 puffs 1-3 mins apart. If symptoms don't get better then call 999 for an ambulance.

Calling for an ambulance where I live will be a very long wait. So If that happens then I will get my husband to take me to A&E. 5 mins journey by car.

May one or two will criticised ne for not calling an ambulance I have before and got one. However lately when I tried ambulance service was very busy so got driven to hospital.

Back to appointment I was asked to make an appointment for asthma review. I haven't had one at GP since last March 2023 because I was under a consultant at the beginning of the year (when I suppose to have one) due to having pneumonia last November with hospital admission.

Telephone appointment next week.

I don't expect any change to my inhalers. I had both covid and flu jabs. Very healthy at the moment. So all good here.

[Poobah in reply to elanaoali]

I'm glad you've now got a clear plan, a booked review and are feeling good. Take care Elanoali.

[elanaoali]

thank you Poobah God bless you

[Debs15safc]

I'm also on a fostair mart regime with up to a max of 8 puffs in total, I also have my blue inhaler to use in emergencies if after fostair doesn't ease my attack, but usually if It gets to that stage it's a 999 call!

[elanaoali]

I did have a blue inhaler when I was on fostair 200/6. I was told not to use it any more because of switching to the new mart regime. I do still have it but I don't use it. I don't know how many puffs there are in it anyway. I agree in an ideal world if the fostair doesn't work when you're having an asthma attack you would call 999. In the past before lockdown I have called for an ambulance and got one. These days I know that if I needed one the nhs would be too busy and one won't arrive before I can get my husband to drive me to my local A & E in 5 mins.

[Leaf_eater]

Hi I'm new to the forum but I am also using the Fostair 100/6. Two puffs morning and night but as you I can use it another 8 times if it's needed. My asthma nurse also prescribed me salbutamol inhaler incase of an attack this is my MART regime. I would consult your asthma nurse.

[elanaoali]

Thanks for your advice. I am having an asthma review next week as I missed out on my last review in March as I was still under care of a hospital consultant (I had pneumonia last November and was hospitalised).