Expert: Marc Rubin, RPh Asthma Educator - 2/9/2010

Question
Hi Marc,
  Thank you for your previous answer regarding asthma meds and pregnancy. I had a question regarding the inhaler. Should a rescue inhaler be used with some shortness of breath and a MILD asthma attack, or only during a more severe one? Some attacks tend to go away on their own without meds. Also, you mentioned the Artrovent? inhaler, which is a class B, but works slightly slower than the Proventil inhaler. Is it better to use when trying to become pregnant? I am finding that even with my controller med, Flovent, I am still needing my rescue inhaler more than I should. Thanks and awaiting your reply.

Answer
Hi Sasha,

Take this link to get an "Asthma Action Plan", an excellent guide to the decision making process to address asthmatic impairment:

http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma_actplan.pdf

Also, you should see about getting yourself a "peak flow meter" like this one:

http://personalbestpeakflow.respironics.com/ , which runs about $25.00

As you will note in the Asthma Action Plan, assessing how you are doing can be done by symptoms and/or peak flow measurement. The advantage of the peak flow meter is that people with asthma underestimate their impairment since they have become accustomed to not have a full breathing ability, and think they are doing fine.

In trying to get pregnant, it really does not matter, and in reality, almost all the patients are on albuterol.

Finally, in regards to your present lack of control, definitely discuss this with your physician. Per the "Rules of Two", if you are using rescue more than twice a WEEK during the daytime, or twice a MONTH due to night-time awakenings,you are not in control.

Also, here is one of the standards of patient asthma evaluation, the "Asthma Control Test":

http://www.asthmacontrol.com/

A score of 19 or below is an indication of NOT being in good control, and the situation should be evaluated.


Hope this helps!

Sincerely,

Marc