Salbutamol inhaler
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Hello In 2015 my husband now aged 73 was taken in hospital twice with breathing problems. He had smoked all his life giving up around 10 years ago so 8 years at the time of being in hospital. He was sent home after the 2nd time with symbicort inhalers 2 puffs twice a day Spiriva once a day and salbutamol 4 times a day 2 puffs. He eventually saw the consultant in clinic after various tests and was diagnosed with essentially asthma with fixed airway obstruction due to years of smoking. He was given a rescue pack but he had never had to use it. We moved from London to the North West 18 months ago and last week end he had a spell of difficulty breathing after stupidily going out in the snow and strong wind. I did think I might need to call an ambulance but managed to get through by extra salbutamol and increasing other inhalers for a few days. I asked him about taking his steroids but he did not want to. He saw the gp on Thursday and told her about it she has increased his preventative inhalers from 2 to 3 puffs but told him he should only use the blue one when he needs to. I also have mild asthma so I can understand why she said this but I think this is more than asthma which is reversible. He coughs lots during the day and brings up mucus if he does his exercises breathing and huffing. He said he needs the blue inhaler 4 times a day and than is what the consultant told him to do. He was discharged back to gp as they thought he needed no further check ups. First of all is this fixed airway obstruction the same as COPD and if so should he not be under a hospital clinic rather than yearly checks by surgery nurse. Any advice would be appreciated.
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Vee2 libralady13
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The blue inhaler (ventolin / salbutamol etc) is the rescue inhaler you only use it when you need to, you do not need it as a regular 4 x daily if breathing relatively ok. Its recommended sometimes to use the inhaler before activity it if you have stairs to climb, before going out for a walk in suitable weather conditions etc. Also as the doctor has prescribed and mentioned. Usually the increased dose is only for the duration of an exacerbation. At the time the consultant saw your husband he could well have needed it 4 times daily. When I was told that I got the shakes on a dose of 4 times daily, it really is only when required. Other medicines help to keep the airways open long and are more effective than the blue inhaler.
Spiriva is ongoing daily dose, a 24 hour bronchodilater. The daily dose should never be increased.
Steroid inhaler meds are also ongoing and only increased as the doctor advises and usually only increased for a duration of a flare up unless the doctor advises differently, ask your husbands doctor for clarification on this. The steroid inhaler is a preventative medicine, it helps prevent exacerbations and inflammation of the airways and lung, it is a medicine that should be taken as prescribed. Usually in combination with an additional bronchodilater.
If your husband is not taking his medicine as prescribe ie not taking the steroid inhaler he will be more prone to exacerbation and wanting more to take the rescue inhaler which is not how the rescue inhaler was intended for use.
Coughing up mucus daily may indicate lung issues such as chronic bronchitis which comes under COPD, or bronchiectasis, which does not. To be sure you need to ask your husbands doctor and consider requesting referral to a specialising respiratory consultant. Normally patients get referred back to a specialist if they have repeated infections during the year. The doctor can also prescribed carbocystein to help keep the mucus more fluid and easier to cough up its always advised to drink plenty of water to help with that also.
~Fixed airway obstruction can occur with asthma and COPD
In later years sometimes asthma can result in COPD, In fact in laters years our lungs deteriorate any way with or without COPD.
Check patient UK on the asthma discussion forum
Check patient UK search top right for medicines prescribed to learn more about them and check the difference between asthma and COPD etc.
Perhaps you and your husband may benefit from attending a pulmonary rehabilitation course this by GP referral its a lung exercise and education programme. You will learn what helps and what doesn't, going out in cold windy weather can certainly cause an exacerbation, mostly paitents would be advised not to do this.
The British lung foundation web pages has lots of information and leaflet downloads also a helpline you can telephone with any concerns you may have.
If you do not reside in the UK approach the Lung foundation in the country you are residing.
Search patient UK, NHS choices and British Lung foundation to learn more about pulmonary rehabilitation programmes.
Hope you find some of this information helpful to you.
To clarify mostly people answering your queries here at patient UK are not medical professionals, (myself included) mostly we are living with COPD, some just diagnosed in recent years some diagnosed over 10 years. Some people answer may be from the country you are living in or not. Be aware UK and countries overseas - medical procedure and advice may vary.
If you mention where you are living this may bring forth more people who can advise you more specifically. What I have mentioned to you here, is from my own experiencing and awareness of how the medical profession and procedure works in UK and even then this can sometimes change from county to county but generally UK medical professionals follow the NICE guidelines and UK patients are often referred to the emc website to check their medications, patient UK, NHS Choices and BLF are pretty good guidelines for people living in UK.
libralady13 Vee2
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