Why am I still wheezing despite asthma inhalers?

Question

Hello doctor,

I have been using Albuterol and a combination of Fluticasone and Salmeterol twice a day for about a month now, but my wheezing has not improved. Even right after using my inhalers, it feels like they have not made any difference. Allergy pills, such as Loratadine or Cetirizine, do not seem to help much either. They even did a chest X-ray and said everything looked fine.

So my question is,

Why do I always feel short of breath?
Why do I continue to wheeze so much?

I have always had asthma, but it has never been this severe.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

As you may know, asthma is part of a group of airway hyper-reactive disorders. These disorders are genetically determined and can vary in severity. It seems that your asthma attacks have become more severe.

I suggest you follow these medications:

Albuterol 100 mcg per dose, taken four times daily.
After 10 to 15 minutes, follow with a combination of Fluticasone and Salmeterol (500/50), taken four times daily initially. Gradually taper this dose over 15 days, then switch to 250/50 and taper it gradually over another 15 days.
Montelukast, available as a single preparation or in combination with anti-allergics, is very helpful in reducing asthma symptoms. Take one tablet daily until your symptoms subside.
A short course of an oral steroid, such as Deflazacort 6 mg taken twice daily, tapered over a week, can also be very effective in reducing airway inflammation. Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

However, if you try all the above treatments and still find no relief, you should undergo some blood tests and consider using nebulized forms of the medications. Nebulization, whether done at a hospital or at home, is often more effective than inhalers.

Additionally, a short course of antibiotics may help eliminate any infection in your respiratory passages that could be causing persistent wheezing. It is also important to avoid or stop alcohol and smoking until you have fully recovered.

I hope this helps.

Please revert in case of further queries.

Thank you.