Hi everyone, ive got a respiratory tract infection develop and started to use the antibiotics from my rescue pack yesterday due to what looks like infected sputum and feeling diabolical. But Im not sure if i am meant to take the steroids as well. I sent our surgery one of those internet messages and i got given a message for seeing a doctor in a weeks time so thats not helpful, i just wanted a quick bit of advice re medicaction today.
So anyone with asthma that is used to using their rescue pack (i had to coerce to get this earlier in the year) what indications do you take note of to start on the steroids. thank you - Sally
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Shirazmataz
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I have asthma, amongst other things, and no longer have a rescue pack, but when I did, I used to start the steroids at the same time as the antibiotics. I no longer have a rescue pack because I now take an antibiotic, Azithromycin, as a prophylactic, and haven’t had a chest infection for about 8 years!
Thankyou Helen. Thats a great result for you, and touch wood that carries on. I think i might just take them and give myself best chance of getting better quickly. I remember having to make a strong case earlier in the year for getting a rescue pack and GP was very reluctant to give it, saying i must check back with them if i use it. So busy getting agreement, didnt get any guidance on use!!
Do you have a lung consultant for your asthma. If so I’d ask if you could be put on Azithromycin. For me it’s been the best thing since sliced bread. It was stopped in November last year because one of my RA meds was changed, and the new drug couldn’t be taken with Azithromycin. I then had 3 chest infections in three months, the last one ending up in pneumonia and 7 weeks in hospital!
That must have been terrible and 7 weeks in hospital. Grim. I hope you are ok now. Was it better to stay on that rather than new RA med?No i find my surgery never think of referring me for any specialist care. I had pulmonary emboli in both lungs a couple of years ago, totally failed to diagnose it and i went to A&E by that stage in heart failure. Couldnt even see a GP just a helper who hadnt got a clue. God knows how staff get supervised. Not easy to change practice here in middle of rural area.
Thanks Knitter, you managed to get one too. Did they tell you when to use it, both bits? At my surgery you have to use their on line system and it usually works well for getting appointments and call backs. I did tell them peak flow right down and measures, i use Fostair 100 no reliever. I have oximeter too and thats down.Maybe whoever did the triage decided i was taking antibiotics so that should be good enough.i think im just going to take the steroids anyway. Im not sure what they do exactly, pos deal with inflamation which must help with sore lungs and coughing. Thankyou for you advise. Sally
Take the steroids. Your fostair is your reliever. Two puffs am and pm as preventer and a further one puff up to another 4 times in between if needed,ie max 8 puffs in 24hrs altogether. It’s a combined inhaler with inhaled steroid snd reliever. Take care and get well soon. We’re all here 24/7 if you can’t get advice anywhere else. A knowledgeable bunch of wheezers and puffers! 🦊x
Ahh thank you Bingo fox i knew i would get the answers here from people who have experience of these things and happy to support each other. I like the knowledgeable bunch of wheezers and puffers!!! To true!!
Hi commiserations, the point of steroids/ prednisolone is for the inflammation in airways so for me when airways are inflamed I get incessant asthma coughing - which then closes airways more & making them more inflamed. It's for this reason I'd take the steroids because I don't want to deteriorate even more and would need airways open to get rid of any mucus (which would also cause me coughing vicious circle) but you could always call the helpline ASAP to check 0300 222 5800. Good luck ××× P
I don't have a rescue pack but yes, steroids are to reduce inflammation. I would have thought it sensible to take them because if the airways are inflamed the Fostair won't be getting down as deep and thus won't be as effective on its own. That's my understanding, anyway, but obviously if you can possibly get a GP to bother with you that is best.
Ah yes that makes sense too thankyou. I have been coughing badly and if you start you cant stop. I was told by receptionist to send another message to get a reply to the questions i identified earlier. Cant see an appointment in a weeks time going to help. But i will go to try and make sure i get another rescue pack if pos. Why is everything a bit of a battle!
I agree, take the steroids as well. On the topic of when to use a rescue pack, I once tried asking a respiratory nurse but unfortunately did not receive a helpful answer.
They really dont want to hand over responsibilty to their knowledgable and experienced patients. I think its got to do with overprescribing of antibiotics and reduction of effdctiveness.
I agree with everyone- take the steroids, but reduce the number gradually as you get near the end of the packet. I would phone the Asthma and Lung helpline and get some sensible advice.
Thankyou Alberta i took them at lunch time so hope it will help with terrible cough and sore chest. Why reduce towards end of course? Is it an idea to wean off?
I think you only need to wean off if you've been taking longer than a short course. I sometimes used to eek mine out if I wasn't feeling better towards end of a short course. ××I haven't been allowed a rescue pack for 10 years since moving from my wonderful GPs in Wimbledon, a right flipping pain. I get that they need to prescibe fewer antibiotics but that's for normal people not lungues like us. Makes me so cross.
Maddening. Very unfair system in Primary Care. I think what our practice will say is you can be seen or have phone consultation same day when you contact them. My reply to that was if ive got chest infection and asthma flare up and temperature the last thing i want to do is to come out to the surgery, spread bugs, and then queue in pharmacy. Still struggling to tell me there are people in the village that can pick up your meds for you. And how does that work. So reluctantly she gave in. What a faff so much easier to give a rescue pack for immediate needs. I dont think they like it if you put a good case.Thanks for your tips, i will bear in mind about cutting down a bit towards the end to eek them out if necessary. 😁
My prescriptions have always come with instructions about cutting down gradually and / or the respiratory nurses have stressed that. I'm sure Peege knows more about this than I do, because I'm only an occasional user. The one time I ran out before the repeat prescription arrived I did not come to any harm.
Many thanks Alberta - ive only got five days in the rescue pack, hopefully things will be better by then! Its very rare i have been given any steroids so am not familiar with using them.
yes i agree, and i have told them i dont find Amoxycyllin effective either and they just quote Nice guidelines at you by text so you cant answer. Absolutely maddening.
I told my gp the amoxicillin didn’t help and now they give me doxycycline
I’m able to order rescue packs but I read early about taking an antibiotic through winter for a few days of the week which they won’t give me. Sick of getting chest infections through winter! Take care
Lower peak flow and finding it "harder to breathe" .... a peak flow of 25% or lower than your normal is apparently the guideline for automatic steroids from the GP
So depending on what you mean by diabolical you may already need steroids
Thanks Chip, thats a useful guide to know, im down from 310 to 260. I meant diabolical because of headaches, temperature, no appetite, listless from bugs along with asthma effects. Feeling a bit better after both contents of rescue pack.
Steroids normally start to work quite quickly and will make breathing easier... in turn easing coughing too
Antibiotics will kill it off if it's becoming bacterial.... which sadly we are more prone too being asthmatic.
I had the same conversation with the advanced paramedic at my GP just this week... which conveniently is an expert in respiratory issues (apparently that's what he spent alot of time dealing with in the ambulance service)
And he said at 20% we would "consider" providing steroids but my peak flow is 30% lower and he said at 25% that would be "automatic steroids according to the guidelines" ... so start them immediately.
I too have an infection and antibiotics/steroids in my rescue pack .... annoyingly I'm also on prophylactic antibiotics but they appear to have missed the mark the last 2 times, but slowed the progression down substantially (which they told me would probably be the case)
how interesting Chip, thanks for the information. We have to be so careful especially at this time of the year to try not to go near anybody with bugs and those coughing in the supermarkets, unfortunately a lot of people do not stay home. So stay safe yourself and have a lovely Christmas - Sally 😁
I also had Doxycycline and steroids for infections and started both at the same time as per advice from the hospital. They are very different drugs with different effects - they don't duplicate each other. I hope this helps.
thankyou Elsa - first time ive had a rescue pack and hardly ever been given steroids when i have a chest infection, never know if they are limiting supply, it always seems a bit hit and miss.😁
I have COPD and not asthma but the rescue pack is the same. Antibiotics and steroids. I have always taken both when I have exasperation . The steroids open up the airways. We are all different and I am not qualified to give medical advice, but the rescue pack has both medications . Hope you get the answer soon. Take care xx.Sheila ❤️
thanks Sheila, thank goodness for everyone's advice here- i am taking both and beginning to improve!! still coughing but not so painful. have a lovely Christmas - Sally 🍾🍰
Hi shirazmataz, I always take both if my sputum changes colour and a cough on top of an infection, due to the steroids stopping it in its tracks whilst the antibiotics take a few days to kick in . I hope you feel better soon.
hi, sorry to hear your not well. I too have asthma bad require rescue pack - Predisilone and Doxycycline . I keep a record of my peak flow and bp. I take my rescue pack as soon as these drop as well as me feeling really rough after increasing my inhalers. Remember if bin doubt speak to your pharmacists who will advise
I rarely take steroids . This is because I dont like the side effects and they depress immunity. I always submit a sputum sample first . If the abs are not effective it might be because I need different ones because the bug is different. When you see your doc ask what is recommended for you. I was previously advised to take steroids long term but didn't, and I've been fine without. Work hard at eating, hydrating, sleeping and exercising well. I take supplements too. Vit D, zinc and fish oil . Finally, years ago I was having regular infections with my asthma and it turned out I had developed bronchiectasis but took doc a long time after multiple abs before I was referred for assessment and diagnosis by specialist. Good luck.
thankyou Bronchi1 - lots of good info, i take Vid D, Zinc and garlic capsules daily, eat well, sleep well, and need to take more exercise. After pulmonary rehab which was good i took up the offer of GP referral to the gym. I must say i though gyms would be very boring but in fact i really enjoyed it and especially the bicycles with videos of cycle tracks from around the world. It cost about £35 for 12 sessions and i mean to return especially in the New Year when it is cold and you need to avoid huddling on the sofa trying to keep warm! 😁
I would take the steroids, they will help with inflammtion. As its only 5 days you don't need to wean or cut down. I am sure you will feel much better after a couple of days on the steroids and antibiotics, good luck on getting another rescue pack, my gp stopped these a while ago x
I have copd, but I was told if chest is tight take stetoids, if sputum changes colour take antibiotics. Always reorder the rescue pack and advise/see gp . I haven't had an infection for ages, thanks to azithromycin.
Definitely take your steroids as well as they will reduce the inflamation. I've just had the fight of my life trying to get some for a chest infection, it took me 4 days before I was successful. I was diagnosed with asthma earlier this year but they still put copd exacerbation on my nhs record 😒
huge commiserations, that is why we need rescue packs so that you can limit the problem as quickly as possible, so the whole thing does not get out of hand whilst you battle through phone calls, messages, receptionists etc etc getting more stressed out whilst feeling rough and coughing your head off! Saves going out too when you are not well with a temperature etc!!!! Do hope you are feeling better now you got hold of some steroids.🙂
Thanks Shirazmataz, you've hit the nail on the head! Having left it too late the first time and paid the price, my fear level is extreme now. The steroids have helped, thank goodness but I do feel that I'm not as good as I could be. I'm speaking with my respiratory nurse on Tuesday so I'll request a rescue pack and a review on my inhaler as I'm still using Sabutamol 2-3 times a day as well as Trimbow. I'll report back the outcome. xx
good luck - hope you get your rescue pack. I will be asking for a repeat rescue pack when i get to see the GP on Thursday. Do hope i dont have to battle for it! xx
The advice from a GP and also my consultant ammounts to 'if in doubt, take the prednisolone'. I prefer not to take it, if I feel I can get by without it, but have been told to use it if my chest feels inflamed.
Hi Sally, i have asthma and bronchiectasis and I would begin my antibiotics and if I feel breathless then I would take my steroids too as well as increasing my inhalers. Sometimes I find it is only the bronchiectasis which is the problem, in that case I would just take the antibiotics. You know how you feel, so trust your instincts. Take care. Maximonkey
My daughter has had asthma since she was2 she now 30 she only gets asthma attacks when she has a cold her asthma is her breathing and coughing oo it's awfull she takes steroid tablets if her coughing is starting to get bad her asthma is mainly in form coughing causing breathing problems
so she has had it since toddlerhood, thats tough. Its pretty hard avoiding other people with colds especially in early stages when very infectious, but havnt developed obvious symptoms. Mine is like that too, colds bring on my asthma attacks.
I was recently prescribed Carbocisteine for sticky phlegm which would not budge. Having been poorly with covid in October, I then caught an RSV some weeks later. I have experienced post nasal drip and asthma type symptoms for many years and prescribed inhalers to manage SOB. Currently, and for several years, now take Symbicort. The Carbocisteine is making a positive difference (only been taking a week) to the thick phlegm sat at the top of my respiratory system. It is not infected. May help you.
It would be helpful for you to have an Asthma Action Plan which details what your very best Peak Flow Score is when well. I call this my green score. When you have an infection what is your Peak Flow score then. If mine drops into the amber range I would be taking my Steroids along with increasing my inhaler usage . If it drops into the Red Range I am usually on both steroids, antibiotics and increased nebuliser and inhaler use. I keep a written record of my scores and self medication.
thankyou redpandalover, that is useful, i have it in my head, but it is good to keep a written record. I feel quite frustrated with my lack of any plan from the surgery. The last time i had an asthma check it was a practice nurse going through a computer tick box exercise and she wasnt able to answer any of my questions. I need to discuss and firm up having an action plan when i see the doc tomorrow.
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Rescue pack of prednisolone- when to start using them 
Rescue Packs
