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

Patient's Query

Hi doctor,

I have taken Albuterol and Advair twice a day for about a month now without any relief of my wheezing. Even right after I take my inhalers, it is like I took nothing. Allergy pills do not seem to help much either, like Claritin or Zyrtec. They even did an x-ray of my chest 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 never this severe.

Answer

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)

Hello,

Welcome to icliniq.com.

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 (combination of Fluticasone and Salmeterol) after 10 to 15 minutes.

Advair 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.

Nebulisation at a hospital (or at home) is more effective than inhalers which you may be using. A short course of antibiotic can also remove any offending organism in your respiratory passages that may be causing the lingering wheeze.