Brief Answer:
Please read the information below and decide

Detailed Answer:
Hello,

Thank you for asking at HCM.

I went through your query and would like to express my opinion as follows:

1. As per your primary care doctor's advice, you would receive a high dose of albuterol. Let me explain how:

Both combivent respimat and Proair contain albuterol. So as per his advice, you would receive at least 10-12 puffs of albuterol during a day.

Also, as per his advice you will receive total 640 mcg of budesonide per day.

2. As per the hospital doctor advice, you would receive low-medium dose of budesonide and also around 3 doses of albuterol sulfate in nebulizer. I usually advise this schedule as a standard treatment of not-so-severe episode of asthma.

Thus, if you have severe symptoms of asthma, I would suggest you to follow your primary care doctor. Otherwise I would suggest you to follow hospital doctor.

I would like to mention here that frequent albuterol administration can cause side effects like tremors, feeling of heartbeats, hypertension, etc.

3. Other thing I would like to emphasize here is the importance of mode of inhalation.

Using inhalers requires quite a bit effort from your side. If you are feeling weak, I would not suggest you to use inhalers that deliver medicines in puffs, in that case inhalation of drugs using nebulization (as suggested by hospital doctor) would be a better option.

In order to suggest you more, I would like to know how your asthma has been over past few months. What are your current symptoms and since when you have them. I would also like to know for how much duration you have used various inhalers, in what dose. When your asthma was totally under control, when the control was lost and what was the trigger.

From these details, I would be able to help you more specifically.

To summarize, in my opinion, both the treatments are more or less appropriate in a way. If your asthma is controlled with hospital doctor's treatment, I would suggest to follow it as the medications are low dose. However, if you have persistent symptoms or severe symptoms, I would suggest to follow primary care doctor's treatment to control symptoms.

Of course, once improved, I would suggest to consult your doctor again to decide the maintenance inhaler therapy for asthma.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask on follow-up. It will be my humble pleasure to help you with best of my knowledge and efforts.

Wish you the best of the health.

Thank you & Regards,

Dr. Parin N. Parmar

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