Pulmicort Inhaler?
Question:
My six year old has asthma. She was diagnosed with it two years ago. Although it actually started fours years ago when she was hospitalized with severe pneumonia. Anyway her doctor put her on Pulmicort Inhaler and I question it. It is supposed to last 200 hundred usage and seems to always go beyond that. I have never seen the "red" warning that it’s low. I question if it works and wonder if anyone else has problems with it. My daughter has had bronchitis twice since she started this medication and other attacks. It seems to be an on going battle and I feel so sorry for her. She has been sick so much. Any input I would appreciate.
Response:
> question it. It is supposed to last 200 hundred usage and seems to always > go beyond that. I have never seen the "red" warning that it’s low. I > question if it works and wonder if anyone else has problems with it.
I am also on Pulmicort. I wrote a computer program for checking when to expect my meds to run out. The red warning and the program have been in good agreement for the over five years I’ve been using/tracking it. Are you sure you are twisting the bottom as far as it will go then back as far as it will go for *each* puff? Ted
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> > question it. It is supposed to last 200 hundred usage and seems to always > go beyond that. I have never seen the "red" warning that it’s low. I > question if it works and wonder if anyone else has problems with it. > I am also on Pulmicort. I wrote a computer program for checking when to > expect my meds to run out. The red warning and the program have been in > good agreement for the over five years I’ve been using/tracking it. > Are you sure you are twisting the bottom as far as it will go then back > as far as it will go for *each* puff? > Ted
I suspect you have nit the nail on the head with your last sentence. Perhaps no one has ever showed them how to use the turbohaler.
Response:
> My six year old has asthma. She was diagnosed with it two years ago. > Although it actually started fours years ago when she was hospitalized with > severe pneumonia. Anyway her doctor put her on Pulmicort Inhaler and I > question it. It is supposed to last 200 hundred usage and seems to always > go beyond that. I have never seen the "red" warning that it’s low. I > question if it works and wonder if anyone else has problems with it. My > daughter has had bronchitis twice since she started this medication and > other attacks. > It seems to be an on going battle and I feel so sorry for her. She has been > sick so much. Any input I would appreciate. > I’m also on Pulmicort and take two doses a day. It supplies 200, so I
know I have about 100 doses, a bit over 3 months. I get confused at when the red indicator comes down the window. I never know whether to stop when the red bottom hits the bottom or when the red is completely gone. I’ve been cautious and have stopped as soon as I see the indicator hit the bottom of the window. I also agree that you must be turning it till you hear the "click" and then back to the left. The Pulmicort inhaler is confusing to know whether you are getting the medication or not, since you can’t taste or feel the medication in your mouth.
Response:
>My six year old has asthma. She was diagnosed with it two years ago. >Although it actually started fours years ago when she was hospitalized with >severe pneumonia. Anyway her doctor put her on Pulmicort Inhaler and I >question it. It is supposed to last 200 hundred usage and seems to always >go beyond that. I have never seen the "red" warning that it’s low. I >question if it works and wonder if anyone else has problems with it. My >daughter has had bronchitis twice since she started this medication and >other attacks.
I have used pulmicort for several years – I have not had any problems. — "We are fighting today for security, for progress, and for peace, not only for ourselves but for all men, not only for one generation but for all generations. We are fighting to cleanse the world of ancient evils, ancient ills." Franklin Delano Rosevelt State of the Union Address – 1942
Response:
Pulmicort turbo Inhaler http://www.twistclickinhale.com/ Instructions for use (and about that red mark) http://www.twistclickinhale.com/1500.htm Webpages are so much nicer than trying to read the tiny little instructions on the device. Lane In my experience, lightning behavior is most easily explained after it has struck.
Response:
> My six year old has asthma. She was diagnosed with it two years ago. > Although it actually started fours years ago when she was hospitalized with > severe pneumonia. Anyway her doctor put her on Pulmicort Inhaler and I > question it. It is supposed to last 200 hundred usage and seems to always > go beyond that. I have never seen the "red" warning that it’s low. I > question if it works and wonder if anyone else has problems with it. My > daughter has had bronchitis twice since she started this medication and > other attacks. > It seems to be an on going battle and I feel so sorry for her. She has been > sick so much. Any input I would appreciate.
I have used pulmicort for several years – I have not had any problems. My Daughter has used Pulmicort for several months to no avail any suggestions.
Response:
Your six year old may not have sufficient strength to get the pulmicort drug out of the Turbohaler device. One problem documented with this particular dry powder inhaler is the need to breathe in through it sufficiently fast to get the drug into the lungs. (There is a risk with all inhalers that poor technique reduces drug getting into the lungs – some inhalers you need to inhale fast through, others work best when you inhale slowly). The Turbohaler delivers different amounts of drug to the lungs according to how fast the air flows through it. The Turbohaler has a relatively high internal resistance (which slows the air down), when compared to the standard "Aerosol pMDI puffer". The effort needed to get the best out of the Turbohaler is therefore higher, and there is a concern that certain patients (the young and the elderly) will not be able to breathe in quickly enough to use the device properly. The company that manufacture it do produce "Turbohaler Trainers" that whistle when the flow rate reaches the minimum level for clincal effect. Your physician may be able to request these from AstraZeneca, the company who make Turbohaler (their Sales representatives frequently visit physicians’ offices) Alternatively, I can offer to send your clinician a new "inhaler trainer" we have developed, which simulates the different inhalers (pMDI, Turbohaler, MaxAir Autohaler, Advair Diskus). It is used in Europe to train patients in the optimum technique for each device. (N.B. I can’t offer this to everyone and their clinician, but if a handful of people want me to do the same, please email me – I look for feedback on its use and value, and how much it needs to be changed. Detail is on the web at www.inspiratory.com , and my email address is as per this post) Hopefully either will help – the drug prescribed may well be the best choice for your child, but it will be a poor choice if the inhaler can’t be used properly. Kind regards Jon Bell
Response:
>Your six year old may not have sufficient strength to get the >pulmicort drug out of the Turbohaler device.
However I don’t think this would affect how many doses it apparently delivers – it’s not the breathing in which grinds the powder from the pellet in the device, it’s the rotating of the base which does this. IMHO this could lead to poor control but not to apparently too many doses being delivered. <snip> — Five Cats
Response:
> Your six year old may not have sufficient strength to get the > pulmicort drug out of the Turbohaler device.
This may be a nit but if you are doing a search it may matter. The device in question is called a "Turbuhalor" not "Turbohaler". Ted
Response:
writes > Your six year old may not have sufficient strength to get the > pulmicort drug out of the Turbohaler device. >This may be a nit but if you are doing a search it may matter. The >device in question is called a "Turbuhalor" not "Turbohaler".
Mine labelled for the UK clearly says ‘Turbohaler’. >Ted
– Five Cats
Response:
Apologies. I did not mean to confuse. Internationally, the names Turbohaler and Turbuhaler are both used to describe the same device. These names identify it as one of four very similar designs of delivery device from AstraZeneca (I believe are codenamed M0, M1, M2, M3). All of these devices require a certain airflow through them for good clinical effect – this is no different to other inhalers. The turning of the knob at the bottom of the Turbuhaler/Turbohaler does not grind the powder. All it does is load a quantity of powder from a "reservoir". Unless the inhaler is upright, and the knob is turned fully one-way then the other, a full dose of the drug will not be loaded into the "chamber" ready for inhalation. There ois a useful schematic at : http://www.pulmicortinfo.com/delivery/1100.htm The break-up of the powder into particles of the best size (to get into the right parts of the lungs) is affected by the speed of inhalation. The turbulent airflow within the device is important. Fast air flows through the device result in better "quality" aerosol (the average size is smaller) so more gets into the lungs, and less is deposited in the mouth and throat. It is useful to consider that Scott and Jen were questioning whether it worked for their child – correctly "priming" the inhaler device ready for use is one step that can sometimes be overlooked (or not taught to users), and inhaling at the best speed for the device is another – failure to do either correctly reduces the chance for the therapy to work to best effect.
Response:
I swear by this steroid! For six years I took first Asmacort, then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t worth a damn. Never got control over my symptoms ’til I started Pulmicort about two years ago. By the way, and this is of particular interest in treating children: the active ingrediant in Pulmicort, budesonide, is available for nebulizer.—jack
Response:
I wonder if this is akin to giving medical advice. Steroids have been clearly shown to be a double-edge sword! Look out for the long-term contraindications. Donna — – Hide quoted text — Show quoted text – > I swear by this steroid! For six years I took first Asmacort, > then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t > worth a damn. Never got control over my symptoms ’til I started > Pulmicort about two years ago. > By the way, and this is of particular interest in treating > children: the active ingrediant in Pulmicort, budesonide, is available > for nebulizer.—jack
Response:
Donna, I don’t think you can call this "giving medical advice," as it is a general statement arising out of personal experience and from the gathering of information from the web, and the poster is not posing as a licensed physician. If a physician gives general advice, as in a syndicated newspaper column, it is still permissable as general information. Only if a physician directs the care of a specific person is an undesirable outcome likely to be actionable. There has been a great deal of discussion here about the side-effects of steroids. I say this not to discourage your contribution, but merely to let you know that the topic has been discussed. Larry – Hide quoted text — Show quoted text -> I wonder if this is akin to giving medical advice. Steroids have been > clearly shown to be a double-edge sword! Look out for the long-term > contraindications. > Donna > — > I swear by this steroid! For six years I took first Asmacort, > then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t > worth a damn. Never got control over my symptoms ’til I started > Pulmicort about two years ago. > By the way, and this is of particular interest in treating > children: the active ingrediant in Pulmicort, budesonide, is available > for nebulizer.—jack
Response:
Please elaborate regarding the long-term contraindications for Pulmicort. – Hide quoted text — Show quoted text – > I wonder if this is akin to giving medical advice. Steroids have been > clearly shown to be a double-edge sword! Look out for the long-term > contraindications. > Donna > — > I swear by this steroid! For six years I took first Asmacort, > then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t > worth a damn. Never got control over my symptoms ’til I started > Pulmicort about two years ago. > By the way, and this is of particular interest in treating > children: the active ingrediant in Pulmicort, budesonide, is available > for nebulizer.—jack
Response:
I will refer you to the manufacturer for that… Steroids are a stimulant and work our systems harder than normal. They put abnormal stress on the body. In turn our personal weaknesses will be the first organs to suffer…could be heart, liver etc. Donna — – Hide quoted text — Show quoted text – > Please elaborate regarding the long-term contraindications for Pulmicort. > I wonder if this is akin to giving medical advice. Steroids have been > clearly shown to be a double-edge sword! Look out for the long-term > contraindications. > Donna > — > > I swear by this steroid! For six years I took first Asmacort, > > then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t > > worth a damn. Never got control over my symptoms ’til I started > > Pulmicort about two years ago. > > By the way, and this is of particular interest in treating > > children: the active ingrediant in Pulmicort, budesonide, is available > > for nebulizer.—jack
Response:
The amount of corticosteroid in Pulmicort is unlikely to have a significant effect of that sort. Prednisone yes. These are different things. The effect of not taking Pulmicort is far more likely to have a significant negative impact on the heart, etc. – Hide quoted text — Show quoted text – > I will refer you to the manufacturer for that… > Steroids are a stimulant and work our systems harder than normal. They put > abnormal stress on the body. In turn our personal weaknesses will be the > first organs to suffer…could be heart, liver etc. > Donna > — > Please elaborate regarding the long-term contraindications for Pulmicort. >> I wonder if this is akin to giving medical advice. Steroids have been >> clearly shown to be a double-edge sword! Look out for the long-term >> contraindications. >> Donna >> — >> > I swear by this steroid! For six years I took first Asmacort, >> > then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t >> > worth a damn. Never got control over my symptoms ’til I started >> > Pulmicort about two years ago. >> > By the way, and this is of particular interest in treating >> > children: the active ingrediant in Pulmicort, budesonide, is available >> > for nebulizer.—jack
Response:
>I will refer you to the manufacturer for that… >Steroids are a stimulant and work our systems harder than normal. They put >abnormal stress on the body. In turn our personal weaknesses will be the >first organs to suffer…could be heart, liver etc.
Gad – you really are clueless. — "What Sept. 11 did was remind us that there are times when we must fight for our country, that, indeed, there are things – our liberty, our democracy, our belief in human rights and human dignity – worth fighting for." Newsday.com editorial – 27 May 2002
Response:
Thanks for the clarification. — – Hide quoted text — Show quoted text – > The amount of corticosteroid in Pulmicort is unlikely to have a significant > effect of that sort. Prednisone yes. These are different things. > The effect of not taking Pulmicort is far more likely to have a significant > negative impact on the heart, etc. > I will refer you to the manufacturer for that… > Steroids are a stimulant and work our systems harder than normal. They put > abnormal stress on the body. In turn our personal weaknesses will be the > first organs to suffer…could be heart, liver etc. > Donna > — > > Please elaborate regarding the long-term contraindications for Pulmicort. > >> I wonder if this is akin to giving medical advice. Steroids have been > >> clearly shown to be a double-edge sword! Look out for the long-term > >> contraindications. > >> Donna > >> — > >> > I swear by this steroid! For six years I took first Asmacort, > >> > then Beclovent (Vanceril) and then Aerobid. Tempted to say they wern’t > >> > worth a damn. Never got control over my symptoms ’til I started > >> > Pulmicort about two years ago. > >> > By the way, and this is of particular interest in treating > >> > children: the active ingrediant in Pulmicort, budesonide, is available > >> > for nebulizer.—jack
Response:
> Your six year old may not have sufficient strength to get the > pulmicort drug out of the Turbohaler device. > This may be a nit but if you are doing a search it may matter. The > device in question is called a "Turbuhalor" not "Turbohaler". > Ted
Not necessarily, in the U.K it is called a turbohaler. Joe Kelly
Response:
>Not necessarily, in the U.K it is called a turbohaler.
Who was it who said: "The Americans and the English are a people separated by a common language?" — "What Sept. 11 did was remind us that there are times when we must fight for our country, that, indeed, there are things – our liberty, our democracy, our belief in human rights and human dignity – worth fighting for." Newsday.com editorial – 27 May 2002
Response:
>> Not necessarily, in the U.K it is called a turbohaler. > Who was it who said: "The Americans and the English are a people > separated by a common language?"
Everything ever spoken was said by Shakespeare, Winston Churchill, Mark Twain or Dorothy Parker. Larry
Response:
This has been said about them: > > Your six year old may not have sufficient strength to get the > > pulmicort drug out of the Turbohaler device. > This may be a nit but if you are doing a search it may matter. The > device in question is called a "Turbuhalor" not "Turbohaler". > Not necessarily, in the U.K it is called a turbohaler.
in Polish Turbuhaler – this is known "nice" game of pharmaceutical companies to give in each country different names for drugs or devices. Advair and Seretide there are this same – Did discover this anybody? No wonder Piotr —- [http://www.am.torun.pl/~pekasz]
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