Showing posts with label drugs. Show all posts
Showing posts with label drugs. Show all posts

Friday, September 27, 2013

On vacation & forgot your meds: what can you do? How long do drugs last in the med cabinet?

Every day at MyAsthmaCentral.com we get lots of asthma related questions. Below are some questions I thought my readers at the RT Cave would enjoy.

Question: I forgot my nebulizer at home i dont have any of my asthma meds what can i do im felling very tight. I normally carry a resuce inhaler with Albuteral and use it in my nebulizer as well but i left everything at home


My humble answer:
First of all, know that you are not the first nor the last asthmatic to do something like this. I’ve done it, and so do many other asthmatic vacationers I see in the ER.


I have a couple options for you.


1. Most pharmacies allow prescriptions to be transferred. If you go to a Walgreens back home, for example, you can go to the Walgreens wherever you are vacationing and just have them transfer over your scripts. You won’t be able to get a new nebulizer this way, but at least they should be able to get you a rescue inhaler. Other pharmacies that will do this are Rite Aid, Walmart, Kmart, etc.


2. In fact, I’m pretty sure any pharmacist would understand your predicament and help you out. I’ve gone to random pharmacies before and have never had a problem having my prescriptions transferred.


3. Don’t be afraid to go to the nearest emergency room. The people that work there will understand your predicament, give you a quick breathing treatment in the ER, and send you home with a rescue inhaler. If you need it, they can also contact the local home health care company and have them supply you with a machine to use until you go home. The doctor there can also write prescriptions for any other medicines you might have forgotten. Since you should never wait too long to treat your asthma symptoms, this might be the best option for you.


4. You might be able to go to whatever home health care company in the area you are vacationing and see if they can hook you up with a nebulizer and vials of meds to last you until you get back home. I’m not positive exactly if they would be able to help you, but you could try.


Good luck!


Question: What is the shelf life of Theodur


My humble answer: Here is a neat article I found concerning the shelf life of medicines.


Basically, most new drugs like Theodur (theophylline) are good for 2-3 years from the date of manufacture. However, once the “original container is opened for use or dispensing, the expiration date on the container no longer applies.” When the product is repackaged for you — the consumer, it is “usually” dated by the pharmacist to expire within one year.


The expiration date of a medicine is the predicted date at which the drug will lose10% of its potency, according to this ABC News post.


The expiration date also assumes you are storing the medicine at the recommended temperature and humidity. According to our own site, theophylline should be “stored between 59-86 degrees F (15-30 degrees C) and away from light and moisture.” This means that it should not be stored in the bathroom where it will be exposed to high humidities during and after showers.


While most drugs like Theodur are not hazardous if used after their expiration dates, the efficacy of the medicine after that date can no longer be guaranteed. Thus, if you are using an expired medicine you may not be getting the expected results.


Question: Is breathing-in more difficult for Asthma patient or breathing-out ?


My humble answer: Believe it or not, asthma is a disease of air trapping. What happens is air comes in, the airways constrict and swell, and air gets trapped in the lungs. While it may feel as though you can’t get air in, the reality is you can’t get air out. In fact, this air trapping is one of the reasons that during an asthma attack it often feels like you can only take in half a breath, or a quarter of a breath.


Those in the medical field may think of this air trapping as intrinsic PEEP. PEEP is air that is left in your lungs after you exhale. Normally PEEP is 2-3 CWP. During an asthma attack, this PEEP increases, thus causing hyperinflation of the lungs (which can be seen on an x-ray). If this intrinsic PEEP gets severe enough, it can lead to a severe asthma attack, and (possible although rare) even death.


This air trapping is also one of the reasons that diaphragmatic breathing is a technique often taught to asthma and COPD patients. The idea is if you give your lungs more time to exhale some more air might escape your clamped down air passages. Of course you probably know your rescue inhaler also works to relax your air passages to, thus letting out this trapped air.


Question: Intal versus Advair for asthma: have problems with asthma (wheezing sometimes) and respiratory allergies. Age 62M. I heard that Advair is a “ramp up” medication for sicker people and has more side effects and causes weight gain. Is Intal less problematic and am I better off with it if it helps or will I create more long term problems by not using Advair right away? Thanks


My humble answer:
You are wise to ask this question. Intal was a popular controller med for asthma in the past, (in fact I was on it in the 1980s) but it is less commonly used today due to much better medicines. It is a anti-inflammatory medicine, but I rarely ever see it used anymore, especially with adults.


The most common asthma controller medicines used today for asthma are inhaled corticosteroids such as Flovent (a ramp up from Intal). Flovent is much more effective for treating inflammation than Intal (at least most asthma experts conclude this).


If you continue to have trouble with your asthma despite inhaled corticosteroid use alone, your doctor might prescribe Advair (or Symbicort). Advair (a ramp up from Flovent) is a combination drug with both Flovent and a long acting bronchodilator called Serevent in it. Advair has been very effective in controlling asthma for many asthmatics, including myself.


There used to be a fear that inhaled corticosteroids had the same side effects as oral corticosteroids (prednisone), but many studies have been done to prove this is not true. If you take your Flovent or Advair properly, and you rinse really well after each use, side effects from these meds should be rare.


In my opinion, if Intal is working for you great. Your doctor may have been wise to have you try it before resorting to inhaled corticosteroids.


If, as you describe, Intal is not working, you might want to talk with your doctor about other options, such as the Advair you mention. Either way, it’s always a good idea to keep in touch with you physician as I’m sure you are doing.


Good luck getting your asthma under control.


If you have any further questions you can contact me by clicking the “contact me” icon above.


Tuesday, September 10, 2013

Research Activities, December 2011: Agency News and Notes: Children"s use of asthma controller drugs doubles


Children’s use of asthma controller drugs doubles
The proportion of children who used a prescribed controller drug to treat their asthma doubled from 29 percent in 1997–1998 to 58 percent in 2007–2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ). Asthma controller drugs, such as corticosteroids, control inflammation, thereby reducing the likelihood of airway spasms; asthma reliever drugs, such as short-acting beta-2-agonists, open up the airways to make breathing easier; and leukotrienes help prevent asthma symptoms from occurring.  


AHRQ also found that during the 1997–1998 and 2007–2008 timeframes:
•Use of inhaled corticosteroids, a type of controller drug, increased from 15.5 percent to 40 percent. Use of other controller drugs also increased: beta agonists (from 3 percent to 13 percent) and leukotrienes (from 3 percent to 34 percent).
•Use of reliever and oral corticosteroid drugs declined from 44 percent to 30 percent and from 17 percent to 9 percent, respectively.
•Average annual total spending for all asthma drugs more than quadrupled from $ 527 million to $ 2.5 billion.  Specifically, spending for controller drugs grew from $ 280 million to $ 2.1 billion and for reliever drugs, the increase was $ 222 million to $ 352 million (all in 2008 dollars).
•Spending for oral corticosteroids fell from $ 25 million to $ 8 million (2008 dollars).


The data in this AHRQ News and Numbers summary are taken from the Medical Expenditure Panel Survey, a detailed source of information on the health services used by Americans, the frequency with which they are used, the cost of those services, and how they are paid. For more information, view Statistical Brief #341: Changes in Children’s Use and Expenditures for Asthma Medications, United States, 1997-1998 to 2007-2008. 


For more information, contact Bob Isquith at bob.isquith@ahrq.hhs.gov or call (301) 427-1539.


Research Activities, December 2011: Agency News and Notes: Children’s use of asthma controller drugs doubles