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Child with nephrotic syndrome, is steroid dependent, gets regular cough. Can doulin nebulizer be given on regular basis?

My daugher is 8 yrs and have nephrotic sydrome for past 4 yrs. She is steroid dependent. she gets regular cough/ sneeze . can doulin nebulizer given to her on a regular basis. will this have adverse or side effects. Recently after her tentative relapse where she recovered after antibiotics but had blood albumin 1.4, she was on stress dose of steroids. we observed squint eyes, which slowly got corrected on its own. eye & neurological doctors found no problem with her eye neithe her MRI/MRV had errors. Also her CSF reports were negative. Steroids are under tapering but she coughs and sneezes regulary and each one increases our pressure. Should we regularly give her nebulizer.
Asked On : Sat, 22 Sep 2012
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Pediatrician, Cardiology 's  Response

Thanks for the query

Here I want to inform about some facts. Boys with nephrotic syndrome had three times higher incidence of bronchial asthma than the general population. Both boys and girls with NS had about three times more allergic rhinitis than the general population. Cough with sneezing without any noisy breathing and respiratory difficulty goes in favour of allergic rhinitis. Nebulisation with duolin will not help in this case. It will be helpful if there is associated narrowing of airways like in asthma as duolin acts as dilator of airways. In allergic rhinitis antiallergic like Levocetrizine, Allegra and allergy controller like montair will be helpful. There are some known side effects of duolin like palpitation, tremor and dyselectrolytemia.

So I would suggest you that you can use duolin nebulisation on as and when required basis particularly when there is assosiated noisy breathing or breathing difficulty. Till then give him Allegra tab. 30 mg twice a day for 5 days and Grllinctus syp. 5 ml thrice a day for 5 days. Consult a doctor to rule out asthma and for long term management of this problem.
As there is no neurological problem at present and all reports are normal. No need to worry for squint problem.

I hope this answers your query well

Wish you and your family good health

With regards
Answered: Sun, 23 Sep 2012
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