Dr. Kaushal Bhavsar
Pulmonology (Asthma Doctors)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had difficulty breathing when I visited a doctor two months ago. I was prescribed Prednisone and Albuterol treatment for a week. Shortness of breath persisted for which I visited the ER and the doctor took a CT scan and I was diagnosed with COPD. Then I went to a pulmonologist who prescribed Trelegy 100 mg and Breztri twice daily. But neither of them seems to help. The pulmonologist ordered two heart tests to rule out cardiac issues and both were normal. If Breztri and Trelegy are ineffective for a person with diagnosed COPD what other medication could be prescribed to offer some relief for shortness of breath? The cardiac issue has been negative with a normal echocardiogram gram and nuclear stress test within the last month. Kindly give your suggestions. I am taking Lexapro 30 mg and with Romuflast I developed some side effects and stopped taking them.
Thank you.
Hello,
Welcome to icliniq.com.
I have read your query and understand your concern. I have gone through the reports you have attached (attachment removed to protect patient's identity). I suggest you try Indacaterol (Glycopyrronium bromide and Lactose) and Tiotropium (Tiotropium bromide monohydrate and Lactose monohydrate) inhaler medications. I would like to know if any PFT (Pulmonary Function Test) was done. Please do answer the questions so that I can suggest you better. I hope this will help you.
Thank you.
Patient's Query
Hello doctor,
Pulmonary function tests were done and as I mentioned, the doctor asked me to continue to Trelegy. O2 levels are not below 92 and are always in the mid-90s. He basically said that the Trelegy or Breztri were the best options. I just want to try something else because I cannot see any improvement. I am wondering if a different type of inhaler might perhaps be worth trying. I have attached a clear copy of the ER diagnosis.
Hello,
Welcome back to icliniq.com.
Thanks for your answer. I can understand your concern. You can try the Indacaterol and Tiotropium inhalers. Oral Acebrophylline (Theophylline-7 acetate and Ambroxol) tablets (oral bronchodilator) can also be used. Non-pharmacological measures like chest physiotherapy, and incentive spirometry (three-ball spirometer) are also useful. Also, answer the following so I can suggest you better
Do you smoke?
Do you have any family history of COPD (chronic obstructive pulmonary disease)?
Is there a familial variant?
Do you do physiotherapy and incentive spirometry?
I hope you find this helpful. Thank you.
Patient's Query
Hello doctor,
I did smoke off and on for many years at a rate of ten per day or so when I did smoke. No history of emphysema in my family. Can you write a prescription for a trial dose of one of the other inhalers you mentioned just to give them a try? Because it makes no sense to continue with the Trelegy if it is doing nothing. Thank you.
Hello,
Welcome back to icliniq.com.
I can understand your concern. Sorry, to say but in online consultation we doctors can not give official prescriptions or certificates. We can only suggest or advise. Thank you.
Patient's Query
Hello doctor,
That reply just cost me $49.
Hello,
Welcome back to icliniq.com. I can understand but in online consultation we doctors can not give official prescriptions or certificates, we can only suggest or give advice. I advised you on new inhalers, physiotherapy, and spirometry to improve breathing difficulty.
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Pulmonology (Asthma Doctors)
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