My Crohn's and Colitis Blog » Cough Variant Asthma » Clinical Pharmacist Lurking
Clinical Pharmacist Lurking
Question:
Why can’t doctors accept that not everyone is a textbook case? People who are sensitive types are more sensitive to medications. They generally only need half doses. thank you mary. It seems everyone finds it easy to find the right meds. on this newsgroup to suit their needs. my daughter is not a typical case.its nice to know that someone out there could take what i’m saying and understand it. kristin
Response:
Ellis, i did not stop the intal and azmacort with her doctors permission. I talked and talked to the doctors and couldn’t get anywhere. They said that her medicine was not causing her moodiness and sleeplessness.
Why can’t doctors accept that not everyone is a textbook case? People who are sensitive types are more sensitive to medications. They generally only need half doses. Unfortunately, sensitive types are more likely to be labeled hypochondriacs because they can feel aches, pains and any other sensation more than the lower-sensitivity person. They’re also very intuitive. I suspect it’s mostly the intuitive-sensitive types who are turning to alternative medicine after clashing one time too many with the typical scientific, pragmatic M.D. Lucky is the person who can find a highly intuitive M.D. They generally don’t have what it takes to survive traditional medical training. Many of them go the short route of alternative medicine. mary
Response:
I think it is more likely that what is setting her off is the untreated post nasal drip. Try giving her some over the counter Triaminic or Benedryl. If this helps you have your answer.
I am not a big fan of Benadryl for asthmatics given that it can thicken phlegm and secretions and cause more problems. If there is no wheezing and the secretions are few and far between you might be able to get away with a dose to help the post nasal drip. It all depends…
Response:
– Hide quoted text — Show quoted text – Ellis, i did not stop the intal and azmacort with her doctors permission. I talked and talked to the doctors and couldn’t get anywhere. They said that her medicine was not causing her moodiness and sleeplessness. So i took her off by my own decision…..but since being off of the meds….all of her moodiness is gone and she is back to sleeping at night. she has had only one attack in 2 years….she has mostly a cough with phlegm and then with meds….it clears up. thanks for the help.. kristin It’s very unlikely the Intal caused the side effects you mentioned, but the Azmacort could have. I had to discontinue Azmacort due to side effects (was getting facial edema [moon face]). I switched to Vanceril, the inhaler recommended in pregnancy, and the side effects went away. Intal is a very safe anti-inflammatory drug, from an Egyptian herb. But it’s weak and has to be taken 3-4x/day continually, which is a hassle. And doesn’t work during an exacerbation. So I would suggest switching to one of the other steroids– Vanceril, Vanceril DS, Pulmicort, or Flovent (not Aerobid, it tastes bad). And using an Action Plan to adjust the dose to keep peak flows in the Green Zone. Increaseing inhaled steroids and using albuterol as needed in Yellow Zone. Also, if she has any post nasal drip from rhinitis (hay fever) or sinusitis; or GE reflux, this also needs to be treated. Best book: The Asthma Sourcebook, Francis Adams, MD 2nd Edition just released. amazon.com Ellis
– Anne Peticolas 5730 Abilene Trail Austin, Texas 78749
Response:
Ellis, i did not stop the intal and azmacort with her doctors permission. I talked and talked to the doctors and couldn’t get anywhere. They said that her medicine was not causing her moodiness and sleeplessness. So i took her off by my own decision…..but since being off of the meds….all of her moodiness is gone and she is back to sleeping at night. she has had only one attack in 2 years….she has mostly a cough with phlegm and then with meds….it clears up. thanks for the help.. kristin
Response:
Ellis, i did not stop the intal and azmacort with her doctors permission. I talked and talked to the doctors and couldn’t get anywhere. They said that her medicine was not causing her moodiness and sleeplessness. So i took her off by my own decision…..but since being off of the meds….all of her moodiness is gone and she is back to sleeping at night. she has had only one attack in 2 years….she has mostly a cough with phlegm and then with meds….it clears up. thanks for the help.. kristin
It’s very unlikely the Intal caused the side effects you mentioned, but the Azmacort could have. I had to discontinue Azmacort due to side effects (was getting facial edema [moon face]). I switched to Vanceril, the inhaler recommended in pregnancy, and the side effects went away. Intal is a very safe anti-inflammatory drug, from an Egyptian herb. But it’s weak and has to be taken 3-4x/day continually, which is a hassle. And doesn’t work during an exacerbation. So I would suggest switching to one of the other steroids– Vanceril, Vanceril DS, Pulmicort, or Flovent (not Aerobid, it tastes bad). And using an Action Plan to adjust the dose to keep peak flows in the Green Zone. Increaseing inhaled steroids and using albuterol as needed in Yellow Zone. Also, if she has any post nasal drip from rhinitis (hay fever) or sinusitis; or GE reflux, this also needs to be treated. Best book: The Asthma Sourcebook, Francis Adams, MD 2nd Edition just released. amazon.com Ellis
Response:
The Intal can be irritating and contribute to the attack. It only works at the beginning of the reaction (see my other post – allergen vs irritant) and does little to stop it once it gets started. For this reason I think it is an OK preventative to take when things are quiet but does little good once the process has started. Steroids are a much better drug for interrupting the cycle. Unfortunately, if I had to pick just one, I would be more suspicious of the Azmacort causing the side effects you mention. Since it took over a month to clear up last time, I think it is safe to say that what you were doing was not helping much. I would try something else. There are two big possibilities. One is that this really is all asthma and what she needed was more anti-inflammatory medication. Switching to higher doses of Azmacort, a more potent steroid inhaler (like Flovent), or oral steroids would be your possibilities. I think it is more likely that what is setting her off is the untreated post nasal drip. Try giving her some over the counter Triaminic or Benedryl. If this helps you have your answer. — Good Luck, CBI, M.D. – Hide quoted text — Show quoted text – in response to CBI, i may have led you to believe that my daughter was having a attack. she wasn’t. in fact she has only had one attack in 2 years. Mostly she just gets a cough and coughs up phlegm and the use of the medication usually clears it up within a week or so. from reading in this newsgroup i think that it sounds like cough variant asthma? this fall it took a good month and a half using intal and azmacort to clear it up.So in response to your saying intal in the middle of an attack is a mistake….is starting it when her peak flows down a mistake too? i have had trouble finding a good doctor for her…….we have a HMO and i’ve seen every doctor in the pediatric office. They all seem to say to keep her on her every day preventitives no matter what the side effects cause. so i’ve basically been gathering information from various places and doing the best i can. i thank you for your help…. kristin
Response:
The best answer is to consult your doctor. It sounds to me like anti-inflammatory medicine may be indicated, preferably steroids. It should be up to you and your doctor to decide whether oral, inhaled, or none would be best. Starting Intal in the midst of an attack is IMO a mistake for several reasons. — Good Luck, CBI, M.D. – Hide quoted text — Show quoted text – hi…. i have a daughter who is 7 years old with mild persistant asthma. She was put on intal(3 times through nebulizer a day )and azmacort inhaled 3 puffs twice a day. She was having some side effects and we took her off her everyday dose and watched her peak flow every day. She had been fine until today . She has a cold and her peak flow is down from 200 to 140. I gave her albuterol by nebulizer and i came back up.. MY question i start the everyday preventitives again……or just use the albuterol until this cold is gone. Don’t know if this fits in with your quick and dirty category…….but hey…..i tried…..LOL thanks for any help,, kristin
Response:
in response to CBI, i may have led you to believe that my daughter was having a attack. she wasn’t. in fact she has only had one attack in 2 years. Mostly she just gets a cough and coughs up phlegm and the use of the medication usually clears it up within a week or so. from reading in this newsgroup i think that it sounds like cough variant asthma? this fall it took a good month and a half using intal and azmacort to clear it up.So in response to your saying intal in the middle of an attack is a mistake….is starting it when her peak flows down a mistake too? i have had trouble finding a good doctor for her…….we have a HMO and i’ve seen every doctor in the pediatric office. They all seem to say to keep her on her every day preventitives no matter what the side effects cause. so i’ve basically been gathering information from various places and doing the best i can. i thank you for your help…. kristin
Response:
i have a daughter who is 7 years old with mild persistant asthma. She was put on intal(3 times through nebulizer a day )and azmacort inhaled 3 puffs twice a day. She was having some side effects and we took her off her everyday dose and watched her peak flow every day. She had been fine until today . She has a cold and her peak flow is down from 200 to 140. I gave i start the everyday preventitives again……or just use the albuterol until this cold is gone. Don’t know if this fits in with your quick and dirty category…….but hey…..i tried…..LOL kristin
So her peak flow is 70% personal best, putting her in the Yellow Zone. The general rule for an Action Plan is when peak flow drops into Yellow Zone (50-80% PB), to use albuterol as needed and add or double the inhaled steroids, in your case the Azmacort. The Azmacort is what treats the swollen bronchial tubes. Intal is not effective during an exacerbation. However, best advice here is call your doctor. BTW did you stop the Intal and Azmacort with your doctor’s permission? Intal has minimal side effects for most and probably should have been continued. The Azmacort dose could have been lowered possibly; any steroid side effects are dose dependent. Ellis, not a doctor
Response:
Hi – I am a clincal pharmacist lurking in this NG. Feel free to email or post questions under this heading…no guarantees I know the answers!!! 
Response:
can i take vanceril (inhaler) and also vancenase AQ together (same day) being as they seem to co;ntain the same ingredient..beclomethasone. what happens if you take too much vanceril..what is too much for an elderly (72) female. can you reply directly to me as i might never find my way back to this site.
Response:
Feel free to email me with questions. I will not guarantee answers to every one, but if its in my brain and "quick and dirty" its yours with my complements!
Response:
Feel free to email me with questions. I will not guarantee answers to every one, but if its in my brain and "quick and dirty" its yours with my complements!
Okay, if you insist . . . We’ve been discussing Singulair side-effects – stiff, swollen, aching hands, body aches and water retention. I still have swollen fingers about 5 days after I quit taking it. Any ideas what’s causing it? Thanx, Mary
Response:
Feel free to email me with questions. I will not guarantee answers to every one, but if its in my brain and "quick and dirty" its yours with my complements! Okay, if you insist . . . We’ve been discussing Singulair side-effects – stiff, swollen, aching hands, body aches and water retention. I still have swollen fingers about 5 days after I quit taking it. Any ideas what’s causing it?
Can’t tell ya in a "quick and dirty" way (my brain) if its reversible or not in this case…..
Response:
Feel free to email me with questions. I will not guarantee answers to every one, but if its in my brain and "quick and dirty" its yours with my complements! Okay, if you insist . . . We’ve been discussing Singulair side-effects – stiff, swollen, aching hands, body aches and water retention. I still have swollen fingers about 5 days after I quit taking it. Any ideas what’s causing it?
NO guarantees – but if the side effects persist 5 days after terminating Singulair, that drug PROBABLY isn’t the cause. The clinical pharmacology data on Singulair does not report either a long half life or persistent effects. When the quick and dirty (i.e. removing Singulair from your regimen) doen’t work – consult your doc!
Response:
hi…. i have a daughter who is 7 years old with mild persistant asthma. She was put on intal(3 times through nebulizer a day )and azmacort inhaled 3 puffs twice a day. She was having some side effects and we took her off her everyday dose and watched her peak flow every day. She had been fine until today . She has a cold and her peak flow is down from 200 to 140. I gave i start the everyday preventitives again……or just use the albuterol until this cold is gone. Don’t know if this fits in with your quick and dirty category…….but hey…..i tried…..LOL thanks for any help,, kristin
Response:
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