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Asthma/asthma meds


QUESTION: are all asthma meds the same? Is there one medication that is better than another? My daughter as asthma. She hardly even needed her nebulizer when we lived in Maine. Now that we live in Fl she's taking it like candy? Would a different med work better? She has albuterol right now.

ANSWER: Hi Joyce,
  I'm very sorry for the delay. I've been having technical issues with AllExperts and using my iPad. A few days ago, I created a response and their software wiped it out. Their tech support has not responded to this issue, nor in the past in prior instances. Anyway, I hope this makes it to you.

 In regards to medications for Asthma being the same, no, there are definitely different types of medications for this disorder. It is not unusual to locate to a different area of the country, and have a dramatic change in allergies and asthma response. Sometimes good, sometimes not so good as new daughter case.
There are significant differences in the pollen in the area, as well as mold due to the high humidity levels that exist in Florida.
  If you have the opportunity to see an allergist with her yet? It's really important to determine what actually are her triggers now that you've relocated down there. This is important so you can identify and minimize the exposure she has to these triggers. The medication I assume she is on now is albuterol. This is a quick relief medication, that is used as a rescue treatment in case of an attack, & as a prep medication before exercise. When patients are very mild asthma, this may be the only treatment they may need. But if the attacks on occur more than twice a week during the daytime hours, or more than twice a month during the overnight with the patient being woken up with coughing or wheezing, then a change of approach needs to be taken, bringing in the use of controller medication. These are taken on a daily basis to reduce inflammation in the lungs and to maintain an overall better quality of breathing. The albuterol is still used as a quick release medication when there is an attack, but once the controller medications take hold, the patient has significantly less need to use the albuterol. The gold standard for controller medication is an inhalation steroid product. It also be used in conjunction with a long-acting version of the albuterol,  a steroid nasal spray, (should there be a lot of running nose and allergy issues), and an oral tablet (montelukast) that blocks the release of chemicals which initiate the asthma attack.
  So, there definitely a number of different therapeutic options that can be brought to use to get her back in control once again. I know it sounds scary, but this is very very commonplace, and it's really not that difficult master. The best direction see you to follow right now would be to see an allergist to determine the best course of action for her to get things under control.
   Equally important to the medication therapy this patient education. I strongly suggest you and your  gain a greater knowledge of asthma so as to best take control of this condition, rather than letting it control her quality of life.
  Here are two great resources for education:
   Http://          American Academy of Allergy, Asthma and Immunology.  Patient education section changes frequently to respond to seasons and challenges.
    Http://      Allergy & Asthma Network / Mothers of Asthmatics.  Great family education site.

Hope this helps, and once again, sorry for the delay!



[an error occurred while processing this directive]---------- FOLLOW-UP ----------

QUESTION: I'm not sure I understand what education would benefit? I agree that its always wise to understand your own medical conditions but outside of that I don't get?
She's had it long enough now to realize that when she has a hard time breathing she needs to take her nebulizer.

    With education, you are proactive..with knowledge and awareness of what triggers the attacks. Therefore, avoiding those encounters, and, if unavoidable, taking preventative measures e.g.: pre-exercise albuterol, or taking a dose of antihistamine with a steroid nasal spray a few hours before visiting a friend with cats you are allergic to. Presently, your child is reactive, taking a treatment after her body has been adversely affected. Quality of life suffers, and a greater risk of a severe attack with dire consequences.
    We always have a choice of these two pathways, but only one will deliver a better quality of life. This applies to all facets of life, but is huge in the area of chronic illnesses, be it asthma, COPD, diabetes, high blood pressure, etc.



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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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