July 2011 Asthma Adviceline Case Study
Damien is 44 years of age. He was diagnosed with asthma a year ago. He has been prescribed Seretide 250mcgs discus 1 puff morning and evening and Ventolin 1 puff when required. Lately he has been feeling very tired. He has no energy and has noticed he is putting on weight. He called the Asthma Adviceline to query if the weight gain is because of the steroids he is taking and if he will have to take them for the rest of his life.
Asthma Nurse's Advice: Damien mentions that he is currently prescribed Seretide 250mcg and ventolin. These are some of the standard inhalers used in the control of asthma.
It is the steroid tablet which is invariably linked with weight gain not the steroid inhaler. The reason is that the steroid tablet may increase a person's appetite and so weight gain usually follows.
However, side effects from an inhaled steroid can include hoarseness and or a candidiasis- a thrush infection. This may be avoided by mouth rinsing and gargling post use of the steroid inhaler and/ or using a spacer device.
Seretide contains an inhaled steroid plus the equivalent of a long acting ventolin. Studies have shown that when these 2 medicines are given together they have a synergistic effect . i.e.; these medicines work very well together when combined and that less of the inhaled steroid may be required to produce the beneficial effect.
The steroid soothes the breathing tubes and makes them less ‘twitchy’, less ‘irritable’ and less sensitive to triggers that might upset one's asthma i.e; chest infection, exercise, pollen, dust etc. It is important to emphasise that the steroid needs to be taken on a regular basis to maintain asthma control.
You may be feeling tired due to your asthma being uncontrolled and this in turn is making you feel you have no energy or inclination to exercise or even perform your normal daily activities. If you are taking your medicines on a regular daily basis as prescribed this tiredness should not persist and if it does you should contact your GP.
In Ireland 470,000 adults and children have asthma. Asthma can start at any time of life Your asthma was diagnosed one year ago. Sometimes it is harder to accept asthma when the diagnosis comes as an adult.
It can be difficult to accept that one may have to take medication on a regular daily basis. It is important to remember that although there is no cure for asthma you can achieve good asthma control, which will enable you to live a normal life.
Control is usually maintained by using your controller inhalers on a regular daily basis and reliever inhaler not more than twice a week. In your case the controller concerned is the Seretide and the reliever is the Ventolin.
If your asthma is adequately controlled in collaboration with your GP you may be able to reduce or even temporarily stop them on occasions but with the understanding that you may also have to restart or increase the dosages as required.
If you have an asthma related query and would like to speak to an Asthma Nurse, call the Asthma Adviceline on 1850 44 54 64.
