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How Can One Identify And Treat Reduced Lung Capacity While On Budecort?

Posted on Tue, 6 Jun 2023

Question: Hello Doc,

Can you please evaluate the attached PFT report and help me understand . My mom is currently taking Budecort 200 from past 1 year one . She has been taking sereflo before that but that caused palpitation and hence she has been taking budecort. I am attaching her latest PFT report can you please tell me whether the lung capacity has been reduced drastically . And any medications need to be adjusted.

Please advice , and even after taking inhaler why the lung capacity has reduced . I am attaching two reports one done today and one done in the month of Dec'2017.

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Yes, lung capacity has been reduced.

Detailed Answer:

Hello,

Yes, lung capacity has been reduced as compared to the previous one.

Along with Budecort, she should try a combination of Indacaterol and Glycopyrronium (ultra LAMA - long-acting Muscarinic antagonist and LABA - long-acting beta2 agonists).

Since these are prescribed drugs, you will need a prescription for them. Her lung capacity is reduced because her disease is progressive in nature.

Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother.

Thank you.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Drkaushal85 (51 minutes later)

Hello doc,

Thank you for answering nt query. As she is a hypertention patient and her pusle rate is always above 95 and after taking seroflo it had gone upto 120 with lot if palpitation

Can you please tell me that tge above prescrubed drugs will not have any side effects and can be taken sos or on daily basis

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Yes, these newer drugs have very less chances of side effects.

Detailed Answer:

Hello,

Yes, these newer inhaled drugs have very less side effects, so she should definitely give them a try. Ideally, these drugs are for maintenance so have to take twice daily, not SOS basis.

Hope I have solved your query. Let me know if I can assist you further. Wishing good health to your mother.

Thank you.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

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

Follow up: Dr. Drkaushal85 (3 days later)

Hello Doc

We repeated the pft from another hospital to check if the technique was not good. Can you please evalute the report and let me know please what other investigations and medication she shud add.

She is currently taking only budecort 200 inhaler twice a day.

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Recent effort is better.

Detailed Answer:

Hello,

Today's report is with better efforts. It is showing slightly higher FVC value than previous one.

Better to try newer ultra long acting inhaled bronchodilators (Indacaterol and Glycopyrronium) and see if she is improving or not.

Does she have any allergies? Is she taking any anti-allergic drugs?

Please reply to the above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother.

Thank you.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Drkaushal85 (44 hours later)

Hello doc,

Can you please guide whether she can use Levosaltbutamol 50mcg - inhaler along with budecort 200MCG.

Is this the same kind of drug which you prescribed in your earlier advice ?

Please advice

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
No, they are different.

Detailed Answer:

Hello,

No, they are different. Levosalbutamol is short acting beta2 agonist (SABA). Indacaterol has ultra long acting beta2 agonist (ultra LABA). SABA are known to cause palpitations.

It is better not to give her Levosalbutamol. Try Indacaterol because it has minimal side effects.

Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother.

Thank you.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Drkaushal85 (39 minutes later)

Hello Doc,

We got the DLCO report also done, Can you please help evaluate the same.
Looking at the same, doc has prescribed one tablet (telekast 10mg )or 3 months and changed the inhaler to symbicort inhaler one puff twrice a day.

My concern is my mom use to feel palpitation with Seroflo inhaler will she not have palpitation with symbicort inhaler?

I am uploading the HRCT and DLCO report please advice .
what is mild degenerative changes in thoraic spine. and mediastinal lymph and esophageal nodes. is this a matter of concern?

Kindly advice

Regards,

Answered by Dr. Drkaushal85 (5 hours later)

Brief Answer:
She will also have palpitations with Symbicort.

Detailed Answer:

Hello,

CT report is normal. No need to worry about non-significant lymph node enlargement.

About DLCO report, she is having reduced value. This means her lungs are damaged due to chronic asthma. Main function of lungs is oxygenation. Since lungs are damaged, oxygenation is hampered and so DLCO is reduced.

Seroflo has Salmeterol and Fluticasone. Symbicort has Formoterol and Budesonide. Salmeterol and Fluticasone are superior as compare to Formoterol and Budesonide. So I don't think it is a better idea to change Seroflo.

About side effects (palpitations), Symbicort will have all the side effects of Seroflo. Telekast 10mg has Montelukast. It is an anti-allergic drug. It is a good drug for allergic asthma.

Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother.

Thank you.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (1 hour later)

Hello Doc,

Thank you doc.

Can you please guide me on the below points
1. Is tablet Telekast 10mg, Mondeslor tablet and Doxolin tablet are same. If yes which one should be taken

one doc has prescribed Telekast to be taken for 3 months
Other doc has prescribed Mondeslor once a day in the night for 10 days Plus tablet Doxolin 400mg half tablet for 10 days

2. Which inhaler she should take , now she is on budecort twice daily 2 puffs each time. But as DLCO report is showing lung capacity has reduced can she stop budecort and start with seroflo will that again cause palpitation ?

Please advice.

Thanks

Regards,
XXXX

Answered by Dr. Drkaushal85 (27 minutes later)

Brief Answer:
All the tablets are different.

Detailed Answer:

Hello,

Telekast has Montelukast plain. Mondeslor has a combination of Montelukast and Desloratadine (antihistamine). Doxolin is an oral bronchodilator. So all three of them are different.

Please let me know:
Does she have known allergies?
Does she have running nose or sneezing or throat irritation?

Please reply me answers of above asked questions so that I can guide you which drug should be started in her case. Honestly speaking, Seroflo is best for asthma. However, Salmeterol will cause palpitations in her.

If she can tolerate palpitations then Seroflo is better than Budecort.

Hope I have answered your query. Wishing good health to your mother.

Thank you.

Regards,
Dr. Kaushal Bhavsar
Pulmonologist

Above answer was peer-reviewed by : Dr. Prasad