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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for asthama with cough

Answered by
Dr.
Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14587 Questions

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Posted on Wed, 19 Nov 2014 in Lung and Chest disorders
Question: Asthama with cough

Actually my mother in law's Case History :
Patient Name : Mrs. P. XXXXXXX XXXXXXX (69yrs) Actually her complaint at that time was
1. for three months she has lost her weight up to 8 kgs
2. She had severe cough and asthma.she could barely walk
3. She wasn't feeling hungry with sticky semi loose stools ( 1-2 times daily)
Tests done :
-Chest X ray : Normal Study
-Spirometry : after this test you have confirmed Asthma
3. Doctor have advised for Gastroenterologist review along with
The following medication was given for a month
a. FORACORT 200 - one cap daily
b. LEVOLIN- one cap four times daily
c. ROMILAST 10mg - one tab daily at 7 pm
d. Omnacortil 20mg - one tab after lunch for 5 days

Gastroenterologist Review:

I have explained the condition to the Doctor and he asked for an endoscopy report and which in turn came out with an biopsy report which was attached to this mail
The following tests have been Done
1. US scan : Report : Normal Study Of Abdomen and Fibroid Was seen in the wall of cervix
(this report was taken to gynecologist and she said that it is quite normal for a fibroid to be seen after menopause)
2. Endoscopy : Report : Gastric Mitotic Erosion Seen ( which they have taken Biopsy)
3. Biopsy : Report : Parietal cell Micro nodular Hyperplasia
4. Stool For Occult Blood: Report : Negative

Doctors Report was:
1. No significance of Carcinoma anywhere
2. Heavy Gastritis
3. BP was present
Tabs Prescribed were
1. Pantocec 1 tab at 7 Am
2. Losar H 1/2 tab everyday
3. Critipro Powder 2 tsp with milk daily
4. Syp. Betonin 2tsf- 2tsf-2tsf
5. Neurokind plus 1 tablet after food

OVERALL IMPROVEMENTS:
1. After using the pulmonary medications her cough complaint and asthma were 95% reduced with which she was feeling comfortable
2. Weight have been improved . First her weight was 44kgs and then increased upto 2 kgs during first 5 days of medication (due to omnacortil) and again she was back to 44 kgs after 3 days of the stopping of omnacortil and then now she improved her weight upto 46kgs (from past 2 months)
3. She is feeling hungry from past 2 months

Present Problem:
1. Mild Cough is persisting with slight sputum (white in color)
2. Very Mild asthma after she comes out of Head bath

Kindly help with the medication in this matter for the present cough problem.Our doctor is out of country for a month so couldnt contact him.

Thank you in advance XXXXXXX
doctor
Answered by Dr. Kaushal Bhavsar 51 minutes later
Brief Answer:
some changes described..

Detailed Answer:
Hi dear, thanks for your question on HCM.
Thank you for your detailed history. I have gone through all reports.
In my opinion you should continue with following medications.
1. Foracort capsules twice daily. No need for levolin as she is well controlled now. You can keep levolin as sos medication.
2. Continue romilast tablet at night.
3. Continue pantosec.
4. Continue antihypertensive.
No need to worry about slight cough with whitish expectoration. No need of antibiotics or cough supressant.
I just want to make sure few things. Is she taking rotacaps in proper technique.
As in my practice I find difficulty in rotacap use in old age. As inspiratory effort is poor in this age. But if she takes it satisfactorily than no need to worry. Gargles after rotacap use is must. So make sure she gargles after rotacap.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother in law. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 4 hours later
Hello sir

Thank you so much for your kind reply sir..
Yes sir she has been using the rotocaps in the right way only. I ve been observing from day 1 itself.
( I ve completed my m.pharmacy sir so I could give her directions all by myself.)
Two queries:
1.After finding the reports can u explain me is there anything to take care about in future?

2.if the cough intensity increases due to winter time what antibiotics can I use? Kindly prescribe me in advance.. It will help me to give her any time during this season.

Thank you in advance

Sudha
doctor
Answered by Dr. Kaushal Bhavsar 4 hours later
Brief Answer:
Get CBC done.

Detailed Answer:
Hello dear, thanks for your question again.

Answer to your first question.
Get done CBC(complete blood count) after 1 month as her Hemoglobin was slightly low. So repeat it. And if it comes low than iron supplement should be started.
Also do PFT(pulmonary function tests) every six monthly for the evaluation of lung function.

About your second question I think you should start macrolide group of antibiotic and cough syrup whenever she develops intense cough.

Hope I have solved your queries. If you are not having further queries, I request you to close the conversation and rate the answer.
Wishing good health to your mother in law. Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
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