RESCUE MEDICATION

Hi All I,m relatively new to this but been diagnosed for about 9 months. I have used a rescue pack a few times after been given by GP. Yesterday i did not feel great and i woke around one in the morning feeling bad. My problem, and i will speak to GP when i can get an appointment, is how do i know when to take my rescue meds. I took the steriods last night afetr being awake for a few hours but did not take the Amoxicillin as i felt i did not hav an infection. I felt slightly better this morning, called the GP but cannot get a phone app until weds. I am unsure if i should take the steriods today or wait until i speak to GP. Any ideas?

jimmy1c

17 Replies

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  • Not sure what your condition is but given that you have a rescue pack at home I wonder is part of your process before you start the antibiotics is to take in a sputum test so they can check what infection you have; is this something you can do? If you start feeling worse get on those antibiotics anyway.

    From personal experience where Gps have advised starting on steroids first but stay off the antibiotics unless I really need them is probably what ended me with me a 18 months of exacerbations and a worsened condition.

    Hope others will reply to you too.

  • Hi outspan

    Thanks for your reply. One GP i saw in the past advised me to take only the steriod and i was fine. I have a telephone app on weds with GP i will heed your advice regarding anti biotic. Thanks again

    jimmy1c

  • Well you may get different instructions because of your particular condition, or because your surgery's policy is different - but:

    If you get a SIGNIFICANT increase in mucous and it remains clear/white (or your usual shade :)) then start steroids and book an appointment for asap.

    If the mucous darkens green/brown or blood streaks and a raised temperature get mucus sample to surgery, emergency GP appointment & start ABs if not seeing GP/ practice nurse same day...

    I thought there is a NICE national policy recently intro'd to grant same-day GP appointments for COPDers (& maybe other chronic conditions) in an attempt to reduce hospitalisations?

  • Hi soulsaver

    Thanks for your post. Your advice is what i was planning to do as i have a telephone app on weds and i will see what comes of that but will contact surgery if i get worse.

    Thanks

    jimmy1c

  • Hello jimmy1c,

    Sorry you're not feeling well, but I'm a bit confused. Steroids take about six hours to kick in, but it's not clear what time you took them and if they were why you felt a bit better this morning. Was your breathing worse yesterday? You can have a flare up without an infection, but If you take steroids they 'mask' your symptoms so you don't always know if there's an infection there or not. And a tip - if steroids disturb your sleep, take them after food first thing in the morning.

    I won't have helped but I don't have a clue what's going on. And isn't three days a long time to wait just for a phone call? Is there a respiratory nurse at your surgery you could speak to?

    Hope you feel better soon. Sue x

  • Good point re taking the steroids after food, otherwise you can get reflux as they make your stomach more acid.

  • Hi watfordgirl

    Thanks for your reply. I took steroids at about 4am this morning and i did feel better when i got up this morning about 9ish. I did,nt push to see the nurse maybe i sould have but i will take steroids only until i speak to GP on weds. Thanks again.

    jimmy1c

  • Hi Jimmy, my specialist respiratory team and my consultant all say that you should start ABs with copd or bronchiectasis if two of the following three things are happening: 1. significant change in colour of mucus, 2. increase in amount of mucus, and 3. feeling unwell. Ive found it a good guide for me, but as I don't know your situation it may not be right for you.

    Steroids are for breathlessness - they will reduce the inflammation which is causing it by narrowing your airways and making it harder to breathe.

    You should be complaining to the practice manager if you are unable to get even a telephone appointment before two days time. Is there a respiratory team in your area? They are always good for advice. If your condition is serious enough to merit a rescue pack, then someone should be available to talk about using it. Rescue packs are not intended to replace medical advice but to cover the out of hours and weekend times when you can't access your GP. If you do decide to use it, you should let your GP or respiratory nurse know as soon as you can.

  • Hi 02Trees

    i suppose i only experienced one of the 3 things I.E. feeling unwell, i also think one of my problems is not being able to cough up sputum because when i do mange this i feel better. I have an appointment with rehab team on 8th of this month where i am hoping for some education and advice on a number of things.

    Thanks again

    jimmy

  • Shouldn't you be given a pamphlet with the rescue pack telling you when to take them ... or would that be too obvious?

  • Hi soulsaver

    GP was very young, i only joined this practice in May, but yes it would seem to be too obvious

    Jimmy

  • Hi Jimmy1c, I had the same sort of problem a while back and did this search on google : "how and when to take copd rescue pack" it will give you quite a few official websites such as :

    psnc.org.uk/halton-st-helen...

    or this one :

    wales.nhs.uk/sitesplus/docu...

    Hope this helps

    Terry

  • Hi Terry

    That wasreally helpful. I have never been given a pamphlet like this before.

    Thanks again

    Jimmy

  • No worries Jimmy, I know it can be a bit scary at first, but we just have to manage it the best way we can eh. My Dr. for instance, will not prescribe prednisolone as a maintenance medicine 'cos he says it is not good long term constant use every day. I have been having exarcebation about evry four to six weeks and he gives me a rescue pack each time and says this is better.

    Anyway, hope the info helps and all the best, easy breathing.

    regards

    Terry

  • Hi terry thanks again keep well

    Jimmy

  • That's really helpful. Thank you.

    Thea.

  • Hi Terry

    I saw my consultant this morning who reckons i am blood receptive to the steriods and glad that i did not take to anti-biotics He has suggested i try a low maintenance dose of steriods but i have to get a bone scan to keep an eye on osteoporosis developing. As i have also been diagnosed some time ago with ceoliac disease which can also affect the bone density this has been identified as something i should be aware of. The only down sise at present is my sleeping or lack of, again something the consultant states can happen with steriods.

    Jimmy

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