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Are Asthalin, Vixim and Budecort the right medication for cough and chest congestion?

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Posted on Thu, 28 May 2015
Question: Dear Doctors
My son is 10 years old and is suffering from cough from 2 days, So his peadritician recommended Asthalin 2 mg tablet, Vixim 200 DT tablet, budecort 0.5 mg tablet, budecort 0.5 mg in Nebulizer, Crocin if fever felt.Doctor said it is chest congestion and should take medicines for 4 -5 days. Our Doctor is good one and he always, Since my son's birth recommended these medicines only when cough and chest congestion noticed in my Son.
My question is :-
1.My Son is not at all Asthamatic, He has no Asthma, never.
2.Why his Doctor prescribing him Asthama's medicines always.
3.Will it harm my son later in life or are there severe side effects of these medicines.
4.Is our Doctor prescribing wrong medicines or He could have prescribed something more safe than these asthmatic medicine.
5.Can you Doctor's Please recommend some easy / soft / light medicine for my 10 year old Son.
6.He is 10 yrs 5 months old
7.Weight is 42 kg.
8.Height is 4 feet 8.5 inches/ 147 cms approx
9.No medical problem ever.

I will be very thankful for your right and unselfish answer and recomendations.
XXXXXXX
Father
XXXX
doctor
Answered by Dr. Tushar Kanti Biswas (58 minutes later)
Brief Answer:
Lower respiratory tract infection & usefulness of bronchodilator & steroid

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Your son has been given Asthalin 2 mg as broncho-dilator as supportive therapy of lower respiratory tract infection presumably bronchiolitis,common in children.
Bronchodilators are frequently used in the management of bronchiolitis, and shows modest improvement of clinical signs or symptoms in some patients ,though more useful in children with significant wheezing (bronchial asthma).Hence difference of opinion exists.
Vixim 200 DT tablet contains Cefuroxime,a broad spectrum antibiotic,usually given in lower respiratory tract infection to cover mixed infection empirically.
However Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection and antibiotic is prescribed to cover secondary bacterial infection.
Budecort 0.5 mg tablet, budecort 0.5 mg in Nebulizer contains budesonide ,a corticosteroid mostly used in bronchial asthma or bronchiolitis with hypersensitivity.
Unlike patients with asthma, children with bronchiolitis usually do not exhibit a favorable response to corticosteroids.
Inhaled corticosteroids are also used in the treatment of acute bronchiolitis.
No beneficial effects are seen in infants treated with either budesonide alone or budesonide in combination with salbutamol(Asthalin) relative to placebo.Hence it can be omitted.
However reduction of duration of symptoms is observed among those children with receiving corticosteroids.
I feel a course of antibiotic like Vixim 200 DT tablet along with mucolytics like Ambroxol Hcl syrup will suffice in most of the cases of lower respiratory tract infections,unless the child has significant wheezing or strong past history of or family history of Asthma,which your son does not have.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Tushar Kanti Biswas (2 days later)
Thank you Sir for your reply, I appreciate it.
I have minimised the dose of medicines for my son.

Sir Kindly clarify that:-

1. Is there any harm giving Asthalin ( Asthma ) medicine to my son when he is not having Asthma.

2.Will there be any problems in future due to this medicine.

3.I have read on internet that people suffer from pain in bones due to this medicine. ( Sir I am worried because I am ankylosing spondylitis Patients).


If you wish to answer Sir Kindly assure me about these medicines too, given to my son from time to time :-

1.Stomach Pain - Dom DT / Sporlac
2.Alerid - anti allergy
3.Ibugesic syrup for fever ( when he was kid )
4.Crocin 1/2 tablet for fever - now at the age of 10 yrs.

One important question Sir :-
When my son was born he had Jaundice for 3/5 days ( all infants have these days said doctor ) no issue about that,
But Sir our doctor gave Gardinal 1/2 tablet Phenobarbital to my son saying the fever will not effect brain etc.

Was that right Sir, because in my childhood I had one attack of epilepsy and doctor's recommended me 5years of Gardinal, and I know it's very strong drug. This is also a very big concern for me from last 10 years.

I will be very thankful to your act of kindness and guidance.

Humbly your's XXXXXXX






doctor
Answered by Dr. Tushar Kanti Biswas (8 hours later)
Brief Answer:
Asthalin in non-asthmatics ,drugs in pediatric usage and neonatal jaundice

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.
If your son is not asthmatic there is no requirement of giving him asthalin (salbutamol),though common pediatric cough syrup often contains salbutamol or terbutaline to cause bronchodilation and presumably better oxygenation and mucus clearance .However there are many other cough syrups which do not contain any bronchodilator and are equally effective as supportive therapy.

Since Asthalin is given for only for a short period for non-asthmatics ( as in your son's case),there is no possibility of any future adverse or cumulative effect of this drug on your son.
Adverse effects are not usually a problem with beta 2-agonists like asthalin when given by inhalation but adverse effects may occur on oral administration.

The most common side effects of asthalin(salbutamol)are muscle tremor and palpitations, which are seen more commonly in elderly patients.
There is a small fall in plasma potassium due to increased uptake by skeletal muscle cells, but this effect does not usually cause any clinical problem.There is no report of bone pain or skeletal side effect of asthalin.
I suggest to avoid any oral preparation containing asthalin(salbutamol).

Other drugs :
Dom DT -usually given for nausea ,vomiting & Sporolac for diarrhea as probiotics-common prescription
Alerid (cetrizine)-common anti-allergic.
Ibugesic syrup contains ibuprofen,a non-steroidal anti-inflammatory drug (NSAID);its use for fever is discouraged.Not a safe prescription as it can cause Gastro-intestinal side effects;to be avoided.
Crocin(paracetamol)for fever -250 mg /half tablet of 500 mg can be given at 10 years of age (maximum single dose 15 mg/kg/dose;maximum daily dose 75 mg/kg/day).

Your son seemed to have neonatal jaundice (physiological as it lasted for 3-5 days).
Phenobarbital is given in neonatal jaundice for enzyme induction _hence to reduce serum bilirubin level( for treatment and prevention of hyperbilirubinemia in neonates),particularly in kernicetrus (brain damage) but it is no longer used these days as there are better options like phototherapy which are regularly used and quite effective ,particularly in physiological jaundice. Its routine use is not warranted.
Even if it has been used in a new born for a short period ,it will not produce any lasting effect.
I hope,I have been able to clarify your queries and allay your concerns.






Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1911 Questions

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Are Asthalin, Vixim and Budecort the right medication for cough and chest congestion?

Brief Answer: Lower respiratory tract infection & usefulness of bronchodilator & steroid Detailed Answer: Hi, Thank you for your query. I can understand your concerns. Your son has been given Asthalin 2 mg as broncho-dilator as supportive therapy of lower respiratory tract infection presumably bronchiolitis,common in children. Bronchodilators are frequently used in the management of bronchiolitis, and shows modest improvement of clinical signs or symptoms in some patients ,though more useful in children with significant wheezing (bronchial asthma).Hence difference of opinion exists. Vixim 200 DT tablet contains Cefuroxime,a broad spectrum antibiotic,usually given in lower respiratory tract infection to cover mixed infection empirically. However Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection and antibiotic is prescribed to cover secondary bacterial infection. Budecort 0.5 mg tablet, budecort 0.5 mg in Nebulizer contains budesonide ,a corticosteroid mostly used in bronchial asthma or bronchiolitis with hypersensitivity. Unlike patients with asthma, children with bronchiolitis usually do not exhibit a favorable response to corticosteroids. Inhaled corticosteroids are also used in the treatment of acute bronchiolitis. No beneficial effects are seen in infants treated with either budesonide alone or budesonide in combination with salbutamol(Asthalin) relative to placebo.Hence it can be omitted. However reduction of duration of symptoms is observed among those children with receiving corticosteroids. I feel a course of antibiotic like Vixim 200 DT tablet along with mucolytics like Ambroxol Hcl syrup will suffice in most of the cases of lower respiratory tract infections,unless the child has significant wheezing or strong past history of or family history of Asthma,which your son does not have. Regards Dr. T.K. Biswas M.D. XXXXXXX