Help with Second-Hand Smoke

[Tammy2009]

I'm having a lot of trouble lately with my asthma control now that I've started classes again.  I seem to be ultra sensitive now (more than I was last year on campus) of cigarette smoke.  I have to walk outside to get to some of classes and if I pass more than one person smoking or get too many wifts in my face, my chest really tightens up and I'm forced to use my rescue inhaler.  The problem is this has been an almost daily occurence and I hate taking ventolin that regularly.  

I am already using 800mcg of pulmicort a day and even at that level it has been giving me muscle cramps and messing up my period, so I don't want to increase it.  

Any comments?  Or things I could try?

[Flattman]

I'd say it's the increased triggers.  Advair can definitely be pricey.  Might look into other long-acting beta agonists.  Serevent is the LABA that is in Advair (Formoterol is available as Foradil.    Salmeterol is the LABA in Advair).  It's basically Flovent and Serevent in one Discus or inhaler.

Symbicort is another combination steroid/LABA (Pulmicort + Formoterol).

I don't know if any combination of those options would be better from a price perspective.

Haven't heard of muscle cramps or menstrual effects with Pulmicort.  800mcg is the 'Turbohaler' version, though, which I rarely use in my patient population (I'm a pediatric RRT).

Unfortunately, if you can't avoid that particular trigger it's likely to keep on a-triggering.

[Tammy2009]

I have tried advair (first medication we tried) but discontious its use because of cost (I didn't have prescription drug coverage and $120 every 2 weeks was a little too hard for a university student like me).  

It's not that my asthma is worse per se .... it's just that the cigraette smoke triggers it and I'm having a lot more exposure and thus triggers -> which is making me use the rescue inhaler more.  

Now that I'm reading my comment though .... that does mean I need to increase the medication or add another in, at least until I'm done university and can get away from the trigger.  

Stupid smokers!!  

[halbashes]

If you are using your rescue inhaler on the daily bases, then your asthma isn't being well controlled.  Has your Pulmonary Specialist ever recommended a Corticosteroid with an LABA?  Symbicort for example includes both Pulmicort, as well as an LABA called Formoterol.  Another example is Advair (Flovent/Salmeterol).  I would definitely recommend seeing your Pulmonary Specialist.