Is there any alternative to Salbutamol for asthmatic women?

Question

Hello doctor,

I am a 55-year-old woman with uncontrolled asthma. I have been using Salbutamol for 20 years. Currently, I am on a Budesonide Formoterol inhaler, but I am still not seeing any improvement. I am scared this could be COPD. How can I tell the difference? I am struggling to breathe even with daily tasks. What other options do I have? Should I see a specialist? I am worried about the long-term effects.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your query and understood your concern.

The key to managing asthma is the regular use of inhaled medications. To achieve adequate control, it is essential to use the appropriate inhalers at the correct dosage with the proper technique.

Here are some differences between COPD (chronic obstructive pulmonary disease) and asthma:

1. Smoking History: COPD is typically linked to a prolonged history of smoking.

2. Allergic Symptoms: Allergic symptoms like a runny nose and flare-ups are more common in asthma.

3. Onset of Symptoms: Dyspnea (difficulty breathing) generally begins at an earlier age in asthma, while it usually appears later in life for COPD.

4. Nature of Symptoms: Asthma symptoms are intermittent, whereas COPD symptoms are continuous without remissions.

Despite these differences, distinguishing between asthma and COPD can sometimes be challenging.

For a newly diagnosed or uncontrolled asthma, the following investigations are recommended:

1. Complete blood count.

2. Serum total IgE levels.

3. Chest X-ray.

4. Pulmonary function test (spirometry) before and after using a bronchodilator.

Frequent exacerbations can be due to:

1. Comorbid conditions like allergic rhinitis, GERD (gastroesophageal reflux disease), or obesity.

2. Incorrect inhaler technique or irregular use of the inhaler.

3. Use of incorrect inhaled medications.

Here is what to do if you are diagnosed with bronchial asthma:

1. Start using your inhalers regularly and discontinue the Salbutamol (bronchodilator) inhaler. Ensure the inhalers are used daily without breaks for at least six months unless directed otherwise by a pulmonologist.

2. Use a spacer with your inhaler.

3. Consult a pulmonologist either in person or virtually at least once a month.

4. Get age-appropriate vaccinations if you have not already.

5. Manage any comorbid conditions you may have.

Please follow all of the above recommendations. Take care, and feel free to follow up with any questions or if you need further investigations.

I hope this helps.

Thank you.