Hi
My son Thomas is on seretide 125, nedocromil, flixonase and ventolin. Since the weather started turning he already has had 1 course of steroids and is now on his first admission of this autumn/winter season. Last year he had quite a few admissions.
Is anyone on Atrovent inhaler - have you found it makes much difference? I am not convinced we have found the right combo of meds for Thomas yet.
Thanks for any advice.
Jenny
How old is Thomas? My baby nephew is on Atrovent (diagnosed at 10mths, now 13mths old). My brother asked me to ask my cons about it as he had never heard of it and was suprised he wasnt given salbutamol, and I was told its actually sometimes more effective than salb in young children due to the way the lungs work. So while Im no expert as to why, it certainly seems to be helping my nephew. Hope this helps a bit!
He is 3.5 I was just wondering if they would give it in addition to the seretide?
Atrovent is a reliever, a bit like salbutamol but acts on different receptors in the lungs. Seretide is a combination inhaler, and contains Serevent (A long acting reliever) and Flixotide (a steroid). So the atrovent is a different kind of inhaler to the seretide that he's on. There is research to suggest that young children respond better to atrovent, but I'm not entirely sure how tested it is and if I would give up my blue inhaler to favour it.
But the atrovent should help in addition to the other meds he is on.
Hope he feels better soon and doesn't have too may admissions over the coming months.
Vicky
Yeah I'm not sure I'm ready to give up the blue inhaler so would want it as extra 
Anyone on seretide, Atrovent and still using ventolin? Soph perhaps?
Hi, if that is any help, I am 39 years old and have been asthmatic since I was 2 years old. My daughter is nearly 3yo and going through multiple bronchiolitis episodes since she was 6mo. Salbutamol (the relief blue inhaler) does not work in young children if used as prescribed to adults (usually 2 puffs from 2 to 3 times a day). Young children have not yet developed their lungs receptors therefore the drug won't be absorbed and metabolised at all. Talk to your doctor about the weaning treatment. I wasn't aware of this treatment until about a month ago and works really well. The below link is purely for reference,. DO NOT CHANGE THE TREATMENT DESCRIBED BY YOUR DOCTOR OR CHANGE IS IN ANY WAY BEFORE YOU CONSULT THE DOCTOR AGAIN. THIS IF FOR INFORMATIONAL PURPOSES ONLY
I used to be on Atrovent, Ventolin and Seretide. Atrovent made a big difference for me, but because my pulmonologist is not a big fan of Atrovent, she took me off.
Hi,
I've had atrovent on top of Seretide, Monteleukast and Bricanyl (which is my reliever). Although it is fast acting, I was also taking Nedocromil for some of this time. I used it more as a preventer but did have to take it four times a day. I quickly found an improvement in my daytime symptoms and noticed if I forgot to take it so it must have done some good even though I was still not fantastic! The only reason that I am not on it now is that most of my symtoms are at night and atrovent wasn't lasting long enough so I am trying Spirivia (which is the same sort of thing but longer acting).
Im on seretide, salbutamol, atrovent and bambuterol at present (plus goodness knows what else!). I take them all regularly with salb and atrovent by neb and do find it makes a difference if I miss a dose of anything. I hope you find a combination that works for him.
Hi Jenny,
I was only thinking about Thomas the other day when my daughters asthma was playing up.
Sorry to hear hes in hospital at the moment-hope you don't have a long stay.
My daughter was on serevent, atrovent as preventer meds and ventolin for relief of wheezing etc
It is a bit of a pain as it has to be taken 4 times a day but she really responded well to it.
She had montelukast added in as she had a lot of night time/early hours symptoms which also really helped and now she has been taken off atrovent but we still have it t home for her step up meds when she has a cold or when she has an attack and ventolin is not helping very well we give her some atrovent and the combination of the 2 inhalers usually keeps her out of hospital, if not off the pred.
I have had atrovent in inhaler form and now reg nebs for years and I find it a really helpful med in conjunction with ventolin.
Hope this info helps and get well wishes to Thomas x
They won't give me a nebuliser for Thomas but am thinking maybe trying to get his consultant to give the atrovent inhaler a go. I know he would have to take it quite a few times a day but I'm willing to give anything a go.
Thomas was on montelukast but had to be taken off it because of behaviour, but to be honest it didn't make that much difference for him.
Only prob is now his consultant isn't til November and they can't bring it forwards apparently 
Hi Jenny,
I used to be on Seretide, but am now on fostair Mart and Ciclesonide. I have been on Atrovent for a long time - even back when I was on Seretide, I use 2 puffs 4 times a day plus as required as I do with salbutamol. I find that when I am having an attack the atrovent makes a difference. I have a neb at home, but corrently only allowed salbutamol (plus as was suggested by my cons when I last saw him during an admission maybe the steroids, but not sure what is going to happen yet as it needs to be discussed at clinic); hoping he may also agree to atrovent. From my understanding though, I think they are pretty reluctant to allow anyone to have nebs at home.
I would give the atro a go, its made a difference to me, its safe to be used with both seretide and salbutamol and it might work on the receptors in Thomas' lungs which cause his attacks? Would be good if it was his magic wand 
is he on anything like uniphylline etc?
Can his GP add atrovent on? It was after an A&E visit over a bank holiday ages and ages ago I was given Atrovent in inhaler form and my GP then prescribed it the sameway as salbutamol is prescribed, then my consultant added it on. I am very tempted to see if my cons will add Spriva instead of atrovent, but more thought needs to go into that!!
Hugs, and hope he feels much better soon xxx
Nope he is only on the seretide 125 2 puffs twice a day, nedocromil 1 puff twice per day, flixonase 1 puff per nostral at night, plus ventolin when required.
Our GP will not add or change any meds Thomas is on, I think it's down to his age as a lot aren't licences for children of his age and partially because our GP seems a little over cautious about him. I am going to try push for something to be done abut his meds on discharge tomorrow as I am not particularly happy. It isn't much just adding an atrioventricular inhaler and don't see why one of the doctors here can't do that!
I can understand their reason for not giving nebulisers for at home but we surely can get to a better stage than this he is only 3.
Hiya!! How are you all holding up? Soo sorry Thomas' lungs are being mean again! Although i'm so glad he got a break from it!!
Yep - i am now on atrovent QDS -i like it, deffo notice when im due it/if i forget it or anything! tastes evil so if you are having issues with him taking inhalers it may be a bit tricky, although hopefully, as its fairly fast acting, he'll do it for the relief of it!
how long ago was his trial of montelulast? my understanding is that behavioural issues tend to be less frequent as people get older - so if its been a while it might be possible to try again - although i guess its not worth it if it didnt help!
Has he ever been on Fostair? My understanding of it is that the particles of fostair are tiny and so possibly more would get into little lungs?? Worth asking maybe??
Hugs to both of you! I'll email you properly another day - moving back to uni tommoz so its a bit crazy here!! 
x
He hates his nedocromil one too but is easily bribed it has a strange smell for an inhaler.
He was on montelukast for around 5 months but there was no difference in his symptoms when we stopped it.
I haven't looked into fostair that much, but isn't it the same preventer as what's in clenil? He was changed from clenil 100 because he was having 3 puffs twice a day and using ventolin every day almost. I don't want to rock the boat too much so quite like the idea for now of just adding on the atrovent. I have a feeling they may refer him with many more admissions as last time I asked about meds his consultant didn't seem too happy changing things perhaps he wants someone more experienced to have that decision?
The nedocroil inhaler looks, smells and tastes strange! It has a minty taste to it but somehow I think that is worse. I had to take it four times a day with atrovent which was awful taste overload!
My GP was reluctant to use atrovent as it is not really used in asthma care but my cons was trying to get as many things to work on different receptors as possible. It is certainly worth asking for as I found my reliever use dropped a lot when on. I think I am going to ask to swap back from spiriva to atrovent.
I think fostair is the same steriod of clenil.
While in hospital this time I have been more disappointed with his care, not by the nurses but by one doctor in particular. After we came in Thomas had 2 back to back nebulisers then another nebuliser one an hour later. They then decided to stretch him to 2 hourly inhalers. I told the doctor for Thomas this wouldn't work yet he still thought it appropriate to push ahead. Luckily when we got onto the ward the consultant overrode this and put him on hourly nebulisers. He was already struggling 40 mins after the 10 puffs.
This doctor didn't appear to have even looked at the notes the F2 doctor had noted including Thomas's meds and the prev history of HDU visits due to deteriorating when nebulisers spaced too soon.
Fostair and clenil do have the same steroid - like Laura, I am on fostair and ciclesonide, with tiotropiun (long acting atrovent type drug). Fostair was preferred due to the very small particle size (I have severely restricted small airways flow) so it gets further into the lungs apparently. I still need home nebs too though. Steroid inhalers vary as to the particle size of the medications and this can make a difference to treatment response - if the particle size is too large, the drug can't get to where it needs to be (according to my resp consultant).
Though Jenny I can understand you not wanting to rock the boat too much. Haven't seen you on here for a while, sounds like Thomas has had a good run up till now. Hope he's on the mend soon and this doesn't spell the start of a rough time...
We have had a pretty good summer with only a few courses of steroids. For Thomas, the autumn/winter is his bad time, last year due to the poor summer it started a bit earlier in August.
Another question how many days predict after an acute attack do you get? Thomas is supposed to have 5 but because his consultant isn't on rounds this week bet we get 3, and he almost always has relapse after 3 days as its not usually enough to get him past the worst of it.
I think the pred depends on the individual - and my pred use is not usual. 'Normally' I have 2 weeks at one dose then taper every three days by 5mg. But often it's for much longer, last year I was on it six months solid. I keep pred and antibiotics at home and have a very low threshold for starting it. Currently I've been on it since start of August.
Well we are home now. I tried to discuss his meds with the doctors on ward rounds but they wasn't having any of it I have to wait for his consultant appointment in November. He got 5 days pred at 25mg per day which I am happy with. I just hate it when it gets to this time of year which I have additional stress this year as my sister has just been added to the transplant list. I want to be there for we but already have a fear there is a good chance I won't be able to as I have to be able to be there for Thomas firstly
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