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Having Pneumonia. Taking Prednisone, Advair And Ibuprofen. Difficulty In Sleeping. Can I Take Nyquil?

Posted on Fri, 29 Jun 2012

Question: I have pnuemonia. I'm on prednisone 20 mg for 5 days and 10 mg my 6th day. I can't sleep. Can I take NyQuil? I also took advair 4 hours ago and 2 ibupropen

Answered by Dr. Gyanshankar Mishra (2 hours later)

Hi,

Thanks for posting the query on.

After going through your query, I would like to comment the following:

1. You seem to be suffering from bronchial asthma with secondary respiratory infection in the form of pneumonia.

2. Prednisone and Inhalers (advair/albuterol) seem to have been prescribed for asthma.

3. I would like to know whether you took both levaquin (levofloxacin) and avelox (moxifloxacin) at the same time. It is absolutely wrong if you took them together since both the medicines belong to the same class of fluroquinolones.

4. The low dose prednisone indicates that you might have had an episode of exacerbation of asthma.

5. Your pneumonia needs to be evaluated & following investigations are required for that:
a. sputum gram stain /afb -culture and sensitivity.
b. Chest Xray PA view.
c. Complete blood count including eosinophilic count.

Your treatment needs to be tailored accordingly.

6. Now coming to your complaint of sleeplessness. It might be associated with your increased asthma symptoms, steroid use or due to anxiety.

7. NyQuil is a medicine intended for use in common cold due to its ingredients it has sedation as its side effect. I would advise you not to take this medication without prescription for sedation.

8. For your sleeplessness, I would advise you to follow proper sleep hygiene (go to bed regularly at the same time, Do not use caffeine like beverages at bed time, Use your bed only for sleeping, etc.). You should also try to control you chest symptoms by proper evaluation and treatment. Please get your treatment optimized by a pulmonologist. If at all sedation is required and it is shown to be due to anxiety then you may take an anti anxiety sedative (like alprazolam) strictly in prescription by your treating physician.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Gyanshankar Mishra (4 hours later)

Thanks. Yes the levaquin and avelox were separate. My doctor also said try not to take NyQuil. But when u r up late? Ill buy melatonin. Yes some I am sure is anxiety. But I really think te prednisone keeps me up the most. My doc sad don't take after the 5 day dose I was given in ER. I was not tat bad just soo tired of fever and slightly more SOB, so ER actually was good as i got xray, prednisone and albuterol all at once! The prednisone? My doc did not think i needed more. I told her its helping so much. So se reluctantly gave me 5 days more and told me take half. This pnuemonia scares me ad not breathing right so I can't sleep? I wanted more here in case I need before my next appt I guess. But since last night? I won't take again. Just Advair and albuterol if I need it also . I seem to be 50% better in two weeks . Done with antibiotics. So I have a new X-ray scheduled to see anyway tomorrow. No. Sputum or blood was taken. Just X-ray. Should I ask for those?

Answered by Dr. Gyanshankar Mishra (1 hour later)

Hi,

Thanks for the follow up.

After going through your follow up query, I would like to comment the following.

1. Please do not prolong your course of prednisone.

2. Chest xray after 2 weeks will definitely give a fair enough ides about the resolution of pneumonia.

3. Remember sometimes prednisone flares up pneumonia!

4. So now, be relaxed & get your X-Ray done tomorrow. If you do not have any chest symptoms now, there is no need of further investigations. However it is always better to get them done if you have not done them as a baseline investigation in your past (mostly blood count and eosinophil count).

5. Get your pulmonary function tests done after control of pneumonia and accordingly get your treatment optimized by a pulmonologist.

6. After control of this episode of pneumonia do consult your doctor regarding influenza and pneumococcal vaccine.

7. Once your chest symptoms are controlled your sleep will very well return to normal. Meanwhile you may consult your physician regarding medication for sleep (eg. alprazolam). Please take it if required under prescription only.

8. Also do learn Peak expiratory flow rate (PEFR) measurement by Peak flow meter and regularly monitor your peak flow readings. Please consult your pulmonologist regarding this.

I hope I have answered your query. I will be glad to answer any follow up queries.

Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

Above answer was peer-reviewed by : Dr. Raju A.T