Even after taking inhalers, why do I continue to wheeze?

Hello,

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Asthma, as you would be knowing, forms a part of airway hyper-reactive disorders. The latter is a spectrum of diseases genetically determined. Your attack of asthma seems to be severe now. I want to know the dosage and frequency of the medicines you are using for asthma now.

I would suggest to my patient to use Albuterol 100 mcg per dose, taken four times daily. It has to be followed by Advair 500/50 (a combination of Fluticasone and Salmeterol) after 10 to 15 minutes. Advair is also to be taken four times initially and gradually tapered over 15 days, followed by Advair 250/50 again gradually tapered over 15 days. Montelukast, which is available as single preparation and also in combination with anti-allergics, is very helpful in reducing asthma. It may be taken one tablet daily till your symptoms recede. A short course of oral steroid-like preparation, Deflazacort 6 mg taken twice daily and tapered over a week also helps tremendously in removing the airway inflammation. If however, you have tried all the above and still do not find respite, you must subject yourself to some blood tests and take nebulized forms of the medicines. Nebulization at a hospital (or at home) is more effective than inhalers that you may be using. A short course of antibiotics can also remove any offending organism in your respiratory passages that may be causing the lingering wheeze. It goes without saying; you must avoid or stop alcohol and smoking till you get completely better.