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What Precautions Should Be Taken When Suffering From Bronchial Asthma?
Question: hi, my mum is 56 years old lady, short and overweight, with hypothyroidism since 5-7yrs on tab eltroxin100mcg, hypertension(6-7yrs) on tab telmisartan 40mg 1OD & tab amlodipine 5mg 1OD, and bronchial asthma since 5-6yrs on serretide accuhaler 1 puff bd & on tab montelucast 10mg. My mum had an eaxacerbation of bronchail asthma 9 months back(admitted for d same), three months back , n one episode recently.the severity of bronchospasm has increased but she has maintained oxygen saturations alwayz during episodes of exacerbation. Can u plz suggest me preventive methods or any change in medications to prevent such exacerbations.
Brief Answer:
Management and evaluation for allergies
Detailed Answer:
Hi.
I am an ENT specialist and deal with a lot of patients who suffer from bronchial asthma because they invariably have associated nasal allergies. It appears as though your mother has been having a few episodes of acute exacerbation suggestive of hyperactive airway disease. Since she has maintained oxygen saturation during these episodes she may have had bronchospasms that did not probably develop into a full attack of asthma.
In my opinion, in order to prevent further episodes, you may consider the following steps
1. Prevention of exposure to allergens. A close watch on surroundings when there is dry cough or sneezes will help identify these triggers which may be tactfully avoided.
An ENT evaluation to look for allergic changes (edema, secretions) in the upper respiratory tract (Nose to the trachea) may be necessary. If allergic changes are seen then Montelukast may not be sufficient and an antihistamine such as Fexofenadine may need to be added. It is also important to rule out any obstructive sleep apnoea which is also coincidental with bronchospasm, asthma and weight gain.
2. Bringing the hypothyroidism under control and reducing weight. Being overweight adds a lot of stress to the lungs and respiratory muscles leading to increased effort even with simple activities. This can be enough to trigger bronchospasms. It is therefore necessary to bring the thyroid functions to normal which will help in weight loss.
3. Review with her physician to evaluate ongoing medications. It is known that medicines like Telmisartan and Amlodipine may precipitate bronchospasm but these incidences are very low (<0.5%). Other alternatives may be explored based on her physicians clinical judgement.
4. Exercises to improve lung capacity with yoga, swimming or brisk walking may be helpful. Do consult with her pulmonologist for a reassessment of lung functions and to discuss these recommendations.
Asthma is a lifelong disease and it can only be controlled to some extent. It is expected for a few episodes of bronchospasm or asthma attacks to recur based on exposure to triggers. A bronchodilator such as what your mother is using should be able to help alleviate her symptoms.
Hope this answer has helped address your query. Do let me know if you need any further assistance.
Management and evaluation for allergies
Detailed Answer:
Hi.
I am an ENT specialist and deal with a lot of patients who suffer from bronchial asthma because they invariably have associated nasal allergies. It appears as though your mother has been having a few episodes of acute exacerbation suggestive of hyperactive airway disease. Since she has maintained oxygen saturation during these episodes she may have had bronchospasms that did not probably develop into a full attack of asthma.
In my opinion, in order to prevent further episodes, you may consider the following steps
1. Prevention of exposure to allergens. A close watch on surroundings when there is dry cough or sneezes will help identify these triggers which may be tactfully avoided.
An ENT evaluation to look for allergic changes (edema, secretions) in the upper respiratory tract (Nose to the trachea) may be necessary. If allergic changes are seen then Montelukast may not be sufficient and an antihistamine such as Fexofenadine may need to be added. It is also important to rule out any obstructive sleep apnoea which is also coincidental with bronchospasm, asthma and weight gain.
2. Bringing the hypothyroidism under control and reducing weight. Being overweight adds a lot of stress to the lungs and respiratory muscles leading to increased effort even with simple activities. This can be enough to trigger bronchospasms. It is therefore necessary to bring the thyroid functions to normal which will help in weight loss.
3. Review with her physician to evaluate ongoing medications. It is known that medicines like Telmisartan and Amlodipine may precipitate bronchospasm but these incidences are very low (<0.5%). Other alternatives may be explored based on her physicians clinical judgement.
4. Exercises to improve lung capacity with yoga, swimming or brisk walking may be helpful. Do consult with her pulmonologist for a reassessment of lung functions and to discuss these recommendations.
Asthma is a lifelong disease and it can only be controlled to some extent. It is expected for a few episodes of bronchospasm or asthma attacks to recur based on exposure to triggers. A bronchodilator such as what your mother is using should be able to help alleviate her symptoms.
Hope this answer has helped address your query. Do let me know if you need any further assistance.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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