Expert: Marc Rubin, RPh Asthma Educator - 6/20/2009

Question
Hi Marc

My 5 year old boy has Cough Variant Asthma and has been recently put on Ventolin and Flixotide (2 puffs twice daily). This has been a great relief for him especially at night when he would be at his worst. (Changes in weather temperature cause the coughing).  But since taking these inhalers for about a month now, he constantly has the sniffles and a runny nose, and now it's affecting his sleep. He's quite miserable with it. What could be causing this?  Brenda

Answer
Hi Brenda,

Asthma, especially when they begin in childhood, are nearly always allergy related. Some of the allergen triggers are year round (like if he has animal allergies...dog, cat, farm animals, and they are a part of your daily life. Other environmental allergens are seasonal: tree pollens in early spring, grasses in the late spring and early summer, weed pollens in the fall. Since this is the time that grass pollens are peaking, it is probable that he is allergic to the grasses, and thus the runny nose. My wife has the same problem, runny nose, runny itchy eyes, etc, that subsides when the pollination ends, usually early July.

Treatment is the nasal spray form of the Flixotide. Speak to your doctor about this. You generally see marked improvement in ~ 3 days, although the symptoms will begin improving sooner.

Keep in mind, when the nasal passages are inflamed, they contain many of the same allergen sensitive cells of the lung airways, and this can result in a worsening of asthma symptoms. This is probably why his sleep is getting affected. The nasal spray indirectly can also result in decreased eye symptoms, even though it is NEVER sprayed in the eyes.

Here are some web sites that are great for you to learn about asthma, and guide your child to healthier life. The first is from the European Lung Foundation. Names of the drug agents will more likely be familiar to you then at the American organization web sites that follow.  (Flixotide in the US is Flovent, for instance)

http://www.european-lung-foundation.org/

http://www.aanma.org/ (Mothers of Asthmatics)

http://www.aaaai.org/patients.stm

http://www.acaai.org/public/

I hope this will help both of you. If you have further questions, always feel free to get back to me.

Sincerely,

Marc