Question:
I've had asthma for 10 years- first 8 years I used a canister of Ventolin a
month. My asthma never restricted me. Two years ago I had to switch drs.
Now I'm on Ventolin, Accolate, Flovent 220. Instead of just worrying about
the asthma, I'm now concerned about possible glaucoma, cataracts, bone
density loss, elevated white blood counts, elevated liver enzymes and who
knows what other long term problems. Since they can't 'cure' asthma, what
is the point? What is wrong with using the Ventolin?
Answer:
Current asthma guidelines call for using a long-acting bronchodilator,
like Serevent or TheoDur for maintenance; not a short-acting
bronchodilator, like Ventolin. Ventolin is still recommended for
'rescue', and for exacerbations. There is some evidence Ventolin loses
some effectiveness when used for maintenance. Flovent 220 is the High strength version of Flovent, prescribed for
those with Severe asthma. At the High Dose level, you can start getting
some of the steroid side-effects you get from oral steroids. To minimize
side effects of Flovent, use a spacer like the AeroChamber (assuming you
are using the MDI version), rinse, gargle, and spit out after inhaling.
Also add steroid-sparing drugs like Serevent, TheoDur, Singulair, to
minimize the need for Flovent; steroid side effects are dose-dependent so
you should use the smallest dose necessary to control the problem. Use of a Peak Flow Meter at home is also recommended; with an Action plan
to adjust meds in response to peak flow readings.
