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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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3 Yr Old Having Frequent And Continuous Cough And Nose Bleeding After Taking Duolin Inhaler. Advice?

my daughter is 3 years old , no past medical history no allergies. she started getting a very bad cough at night ans early mornings, went docs did a chest x ray was clear, as her father has asthma the doc precribed her the duolin inhaler 2 puffs every four hours. She has been taking for two days, the cough is more frequent now and more continuous and she had a nose bleed yesterday after an hour of taking the inhaler- not sure if its related. im just worried the inhaler is making it worse please help
Mon, 18 Jun 2012
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Allergist and Immunologist 's  Response
Hello,
Chronic cough at night and early mornings is a suggestion of airways disease such as asthma in most children.
NO alterations in diet is recommended unless a specific food allergy is proven. Cow's milk allergy and cough is controversial and not proven, so please get allergy tests (blood tests or skin tests) and get an allergy diagnosis before changing diet.
Reflux disease (acid in stomach) is also a possibility, and syrup omeprazole 20mg with or without domperidone daily for 3-4 weeks trial is recommended.
At the same time, continue duolin inhaler and add singulair 4mg at night.
Nose bleeds to inhaler device suggest wrong technique of administration, so suggest get a spacer device to attach to end of inhaler (children must always be provided with a spacer device).
Allergy to house dust mite, cockroach etc are always important to exclude as avoidance of further exposure is key.

I hope that was useful.
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Allergist and Immunologist Dr. Suman Kumar's  Response
stop all milk and diary products till she is 5 years

no antibiotics/no steam,

syp fexofenadine 30mg 1 tsf twice a day
tab montelucast 4 mgm twice a day
syp ventrolin 1/2 tsf thrice a day
syp tossex i/2 tsf twice a day
give for 3 weeks
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3 Yr Old Having Frequent And Continuous Cough And Nose Bleeding After Taking Duolin Inhaler. Advice?

Hello, Chronic cough at night and early mornings is a suggestion of airways disease such as asthma in most children. NO alterations in diet is recommended unless a specific food allergy is proven. Cow s milk allergy and cough is controversial and not proven, so please get allergy tests (blood tests or skin tests) and get an allergy diagnosis before changing diet. Reflux disease (acid in stomach) is also a possibility, and syrup omeprazole 20mg with or without domperidone daily for 3-4 weeks trial is recommended. At the same time, continue duolin inhaler and add singulair 4mg at night. Nose bleeds to inhaler device suggest wrong technique of administration, so suggest get a spacer device to attach to end of inhaler (children must always be provided with a spacer device). Allergy to house dust mite, cockroach etc are always important to exclude as avoidance of further exposure is key. I hope that was useful.