Expert: Marc Rubin, RPh Asthma Educator - 10/9/2009

Question
QUESTION: Dear Sir,
I am 30 Year old married male and i have asthama problem since my childhood age 12 Years. I try several medician as per instruction of Doctors but this take effect only temporary solution. Please help me to solve my problem for Permenent. Just now i am taking folling Medican.

Ventoline Inhaler (As Per Needed or Asthama Attack)
Tab: Theograde (When ever feel chest infection)
Tab: Britanal
Cap: Augmintan 625mg or Cap: Klaricid 500Mg (When So Much Chest infection only for 5 Days)
Clinil Pulvinal Inhaler (2Puff Morning 2Puff Night)
Ventoline Solution or Bronkal Solution with Nebulizar (At the Time of Asthama Attack)

ANSWER: Hello Shahrukh,

Unfortunately, asthma is not a condition that can be permanently cured. It needs to be kept under control as best as possible by the use of both medication as well as avoiding those things that bring on an attack.

When I attempted to dheck the medication you are on, I was unable to verify the actual chemicals in Theograde or Bricanal. They are probably theophylline and terbutaline, but I cannot be certain. Drug names vary around the world, and sadly, the same name is given to two different drugs that are not at all alike. This has created dangers for people who travel the world.

I feel that the biggest challenge for you is controlling your exposure to things that irritate your lungs, like dust, smoke, pollen, mold, insect waste,  animal dander (the dead skin that sheds from the animals skin), and weather changes. This does not include the possibility of food allergies too.

If you can give me some background of where you live (city or rural (farmland), the type of job you have and if it exposes you to chemicals or fumes, and how you cook your food and heat your home, I may be able to give you better guidance. Keep taking your medicines, it seems like your doctor is doing good, but drugs can only help so much.

Get back to me when you can. I will not be available from Monday next week until the following Monday afternoon.

Sincerely,

Marc

---------- FOLLOW-UP ----------

QUESTION: Dear Mr. Marc,

First of all thanx for your reply. I am giving you both medician generic name which will give you the best idea for these medican.
Tab: Theograd (Theophylline:350mg)
Tab: BRICANYL or BRITANAL (Terbutaline:2.5mg)
Cap: Augminten (Amoxicillin)

Backgroun:-
I am originally from Pakistan City Hyderabad but now a days i am in Saudi Arabia City Jeddah due to my Job. I am Telecom Technician and my responsibilities is maintenance of System installed in Exchanges. I make my food my self in Corn Oil, Mostly i use Mutton, Chicken, Different Vegitable, Rice. Temperator in my living city normaly 36-48 Degree Centigrade during March to November and December to Feb Normally 25-35 Degree Centigrade. So no need heat my home. Just open the Doors for Sun Shine and Fresh Air.


Thanx

Shahrukh

Answer
H Shahrukh,

Sorry for the delay, my father-in-law is seriously ill after open heart surgery, and has been non-responsive. A bit of stress around here. Also, I'll be our of town from Tuesday afternoon until the following Monday. If you send me a message, I'll get back to yo as soon as I can.

Have you had any allergy testing done in the past 2 years? If not, I'd have the skin testing done to see if we can identify any subtle triggers. You may want to change to a different cooking oil, since corn is a well known trigger for a number of patients.

Also, if you go to see the doctor, ask if on your blood test if either your eosinophils or neutrophils (or both) are elevated. If they don't have that information, ask for the blood test to be done. If the eosinophils are elevated, Singulair (Montelukast)is very effective in helping to control symptoms. It is a tablet taken nightly, and would be an add-on to your present therapy.

At least in your job, computer equipment is kept at consistent tempuratures and dust-free environments.

Let me know what you find out.

Talk to you soon.

Sincerely,

Marc