Fostair 100/6

[4sibbs]

I post on behalf of my 94 year old mother she has never smoked but my late father did and mum was diagnosed with Emphysema in the 1980's. She has been in a care home for nearly 6 years with various problems one of them being COPD. I have just discovered that her GP has taken her off of Salbutamol which she has been on for many years and replaced it with Fostair 100/6 she is also on Formeterol 12mcg twice a day. The instructions for Fostair are one puff twice a day which means she has no other inhaler if/when feeling breathless, previously she coould take Salbutamol as and when needed.

My question is should Fostair be given as a replacement for Salbutamol because from what I have read it is more like Seretide which is a preventative, the situatuion we find ourselves in is that there is nothing she can have to help her once she has been given the Fostair twice a day e.g. she felt unwell overnight and the carers told her she could not have the inhaler again.

Any advice would be appreciated as I intend to contact her GP on Monday morning

[Troilus]

Hi sibbs You can use Fostair 100/6 as a reliever, but you must not exceed 8 puffs. I had this inhaler for a while but I also had a salbutomol inhaler. I don’t know if your mum would find this confusing.

If so, it might be worth asking if she could have a Fostair 200/6 which she would take in the morning and at night and the rest of the time she could use a blue inhaler.

[4sibbs in reply to Troilus]

Hi, thank you for your reply what mum really needs is an inhaler to take more than twice a day, the Fostair she has been prescribed is only for one puff twice a day which is not enough for her, they have taken the Salbutamol away. I will speak to her GP about reinstating the Salbutamol or increasing the dose of Fostair, it is so annoying when they change medication without an explanation and telling the family.

Thanks again

[Azcowboy in reply to 4sibbs]

My question is why did he take her off. She's 94 years old. Make him make her comfortable for God sake. What, he's afraid it will kill her? Had a uncle who was dieing of brain cancer. Back then you could smoke in rooms. Anyway his requests were a carton of Camels, a jug of whisky and a case of Pabst Blue Ribbon. He lived long enough to finish TWO of each.

And God bless your Mom

[Troilus in reply to 4sibbs]

One thing I forgot to mention was that the Fostair 100/6 is a long acting inhaler. It works as quickly as a blue one, but it lasts up to 12 hrs where the effects of a blue one only lasts 4 hours. So if your mum was taking a lot of the blue maybe he was thinking she could get a longer lasting better result on fewer of the Fostair.

If she is only taking one puff in the morning and one at night, that would leave 6 for the rest of the time.

Whichever way you look at it though, you are right, it is best to have a chat with him.

I agree that it is very important that doctors should keep an elderly patients close relatives informed of any changes to meds and the reasons behind the changes as you are the person who is the best position to explain it if there is uncertainty. I think I would also make it clear that you want to be kept informed of any changes.

[Troilus in reply to Troilus]

The “he” I make reference to is your GP.

[4sibbs in reply to Troilus]

Thanks again I have spoken fo her GP he has reluctantly put her back on Salbutamol, he did say the slow release was better but my argument is that she is also on Formoterol which is slow release too. I did some research on the ‘NICE’ website and it says ‘people should be advised to keep a separate short-acting bronchodilator available at all times for the treatment of acute asthma attacks’ I therefore think I have made the right decision for mum but I will be taking her to the COPD nurse for a medicine review.

[Troilus in reply to 4sibbs]

I’m pleased you have got it sorted and your mum can continue with a familiar regime. Seeing her COPD nurse is also a good idea.

[Bet31]

I am on Forstair twice daily and find it very good I also have a reliever if I need it. GP told me that to increase the dose would not make a difference. Hope this helps a bit.

[4sibbs in reply to Bet31]

Thank you, the problem we have is that mum is in a residential care home & the staff can’t deviate from the GP’s instructions on dosage, they have reluctantly agreed to reinstate Salbutamol which we believe she needs

[Bet31 in reply to 4sibbs]

Hope it all works out for her