Inhalers to Nebulizer Meds

[japdip]

I recently, with the approval of my Physician, switched from Inhalers to Medication via nebulizer. I had previously used Advair 250/50 bid and Xopenex Inhaler PRN. First for financial consideration I requested this change. I am now using Pulmicort 0.25 via nebulizer bid and noticed some improvement almost immediately even without the addition of the bronchodilator. Tracking the difference with my Peak Flow Meter I decided to add the Xopenex 0.63 in the evening prior to the Pulmicort. Since my numbers are very near normal for my age & height. I'm thinking this was an excellent move ... am I correct? Aside from the better numbers I rarely experience any shortness of breath. I'm very interested in your opinion.Thanks

[National Jewish]

The most important criteria for judging the appropriateness of therapy is its effectiveness at a dose that minimizes side effects.  It appears that you and your physician have achieved that goal with the combination of Pulmicort Respules™ (budesonide inhalation suspension) and Xopenex® Inhalation Solution (levalbuterol).  One of the most important elements of asthma management is monitoring, with the results of that monitoring used as a guide for the need of more medication or the opportunity to reduce medication, respectively referred to as step-up and step-down therapy.

The measurement of peak flows can be most useful in this regard.  But, rather than relying on so-called normal values, for which there is a wide range, it is preferable that you compare your values to your personal best.  The personal best being the highest peak flows that you are capable of, at a time when you are symptom free and your lungs are clear.  Another way to look at how well your lungs are working is with simple lung function testing, called spirometry, another way of measuring the openness of your airways.  With this testing, comparison with 'normal values' has more validity, especially the measurement, FEV1/FVC.  You should discuss this with your doctor.

You should stay with your present regimen for 3 to 6 months.  If at that time, your asthma is still very well controlled, you and your doctor may decide to cut back on your asthma medicine doses.