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Suggest treatment for bronchial spasms, wheezing and cough

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Posted on Sat, 30 May 2015
Question: Yes, my girlfriend caught from me a viral infection and now she has bronchial spasms. Last Saturday, she would have wheezing whenever she coughed. We went to the doctor last Sunday and she was presecribed an steroid inhaler (advair) and she has been taking cough syrup (codeine and gualfeniene). She was feeling better thru Wednesday, but felt worse yesterday and is having more spasms again. Is there anything she should be doing to get better? How long does it take to get this out of her system?
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Answered by Dr. Muhammad Sareer Khalil (2 hours later)
Brief Answer:
Likely to be allergic asthma, further evaluation needed

Detailed Answer:
Hello and Welcome

I appreciate your concern

The symptomatic treatment with advair and the cough syrup would have resulted in some degree of improvement and stability till now. Further evaluation is required. If the physical exam does not reveal anything serious then the dose of the advair can be increased and spirometery can be advised to look for a diagnosis of asthma which is an airway disease involving hyper reactivity of the airways. Patients can be allergic to a specific allergen and that should be avoided along with medications like inhaled corticosteroids/beta agonists/LTR antagonists for treatment and prevention. If asthma is diagnosed and the advair alone is not leading to remission of flares or the flares are recurrent then LTR antagonists like montelukast can be added for long term benefit. Upon assessment if there is severe wheezing , pulse oximetery and ABGs should be done. Fever should be checked and an X ray chest be ordered to look for other suspected causes. You mentioned a viral infection, if such viral infections dont resolve then they can be followed by superimposed bacterial Lower respiratory chest infections. She should be assessed for requiring antibiotics if the need be.

In short, this condition needs further assessment especially since advair isn't helping her. I will recommend she consults a chest physician.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.


Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2907 Questions

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Suggest treatment for bronchial spasms, wheezing and cough

Brief Answer: Likely to be allergic asthma, further evaluation needed Detailed Answer: Hello and Welcome I appreciate your concern The symptomatic treatment with advair and the cough syrup would have resulted in some degree of improvement and stability till now. Further evaluation is required. If the physical exam does not reveal anything serious then the dose of the advair can be increased and spirometery can be advised to look for a diagnosis of asthma which is an airway disease involving hyper reactivity of the airways. Patients can be allergic to a specific allergen and that should be avoided along with medications like inhaled corticosteroids/beta agonists/LTR antagonists for treatment and prevention. If asthma is diagnosed and the advair alone is not leading to remission of flares or the flares are recurrent then LTR antagonists like montelukast can be added for long term benefit. Upon assessment if there is severe wheezing , pulse oximetery and ABGs should be done. Fever should be checked and an X ray chest be ordered to look for other suspected causes. You mentioned a viral infection, if such viral infections dont resolve then they can be followed by superimposed bacterial Lower respiratory chest infections. She should be assessed for requiring antibiotics if the need be. In short, this condition needs further assessment especially since advair isn't helping her. I will recommend she consults a chest physician. Wishing you best of health Thanks Please consult your doctor before deciding on any further course of action. Dr. M.S. Khalil