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Reactive airway due to virus. Taking xopenex medication. Chest X-ray clear, spirometry normal. Okay to use inhaler?

I have a reactive airway from a virus for the past 3 weeks. Had spirometry done (normal) and clear chest X-ray . No fever, clear mucus / post Neal drip....causes gagging, coughing, laryngeal spasms. Taking xopenex to open airway (works well) and on last to days of Medrol pack. Only problem is the xopenex makes me very jittery, extreme fatigue,headache, increased HR until it starts wearing off after about 3-4 hours. At about 5 hours I can feel my airways starting to constrict...I try to get to 6 hours so I can avoid the side effects. I have been using the inhaler every 6 hours for the past couple of weeks. Questions 1. Is it ok to keep usIng like this until the virus is gone....repeated side effects? 2. Can one become dependent.....therefore needing every 6 hours or is it because there is still illness and the inhaler simply wore off? 3. Is an antihistamine like Zytec ok to take to try to dry up the PND?
Asked On : Tue, 10 Jul 2012
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Pulmonologist 's  Response

Interesting question. You seem to be well read. However there seems to be some communication gap. You said that the airways constrict. You mean airways in chest or the nasal passages? I suspect that you mean that your nostrils get blocked (because your spirometry is normal). Nostrils normally get congested (swollen) and they do get blocked. However they do not constrict because there no smooth muscles in the nasal passages!

Normally, a virus infection does not last for 3 weeks. So this is post viral reactive airway causing airway (here I mean chest airways) constriction and post nasal drip. If the drip/ phlegm turns yellow, suspect a superadded bacterial infection and take antibiotics.

You have already been put on steroids (medrol). I suggest that you start inhaled fluticasone + formoterol combination for 3 weeks or so (if you mean the chest airways) OR start a Fluticasone + azelastine nasal spray (if you mean nasal airways constriction). A non sedating antihistaminic, such as levocetrizine with montelukast will help.

There is no addiction potential to any of these medicines. However nasal decongestants do cause rebound congestion. So avoid them.

-Dr. Tushar
Answered: Wed, 18 Jul 2012
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