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Saturday, March 8, 2008

Serevent really is the 'true asthma miracle drug'

Today I wish to channel my energy better than I did in my previous post. Today I wish to talk to you from an asthmatic/RT perspective. The topic for today is Serevent and Advair. What I write about today should not only benifit asthma patients and parents, but provide useful information for RTs and Drs as well.

Serevent really is the 'true asthma miracle drug', and while I had trouble taking it at first, I discovered a method of actually weaning myself onto it, and my asthma has never been better. Before I go into more detail, bear with me here, because I'm going to give you a bit of background.

First off, I want you to know that Advair is a combination of Flovent and Serevent, and in this post I do not intend to talk much about the Flovent part of Advair, but I will have no choice but to mention it briefly. In general, this post is about Serevent whether you get it by itself or in a combination with Flovent.

Serevent has been around for more than ten years now. It's a medicine that acts as a long acting bronchodilator and is used to prevent asthma attacks, and is not to be used as a rescue drug. Some people have used it as a rescue drug, and I think that's how Serevent gets a bad rap in the media at times. When used appropriately, Serevent is a very safe and effective drug.

Essentially, the Serevent particles sit in the lungs, and, every hour or so some of the particles open up and the bronchodilator portion of the particles connects with the Beta 2 agonist cells in the lungs and works to dilates the bronchioles.

(For more information about Serevent, check out this link to National Jewish Medical and Research Center. Believe it or not I spent time there once for my asthma, so I'm going to link to them often.)

In this way, the lungs of a person taking Serevent should always be dilated, decreasing the need for a rescue inhaler.

Flovent is a steroid inhaler. It works to reduce inflammation inside the bronchioles and, thus, making the lungs stronger. Likewise, Flovent also works to create more Beta 2 receptor cells for the beta agonist (Ventolin or Serevent) to bind with, thus making those medicines work better.

For some asthmatics, Flovent alone works fine. For some asthmatics, Serevent alone works fine. However, if you need both, it's much more convenient, and makes us patients much more compliant, when we can simply take one puff of Advair twice a day. In that way, Advair is a great medicine.

But that's only half the story.

Ten years ago I spent 10 days in the hospital because of my asthma. In fact, that was the last time I ever had to go there because of my asthma.

After that visit, I was first introduced to Serevent and Flovent by my doctor. At this time I was still using my Albuterol inhaler on a regular basis throughout the day. And, as you might expect, the combination of the two bronchodilators made me extremely jittery. It was so bad it actually effected my work, so I quit (taking Serevent, not my job).

Many of my patients and asthmatic friends told me they had a similar experience with Serevent, whether they used Ventolin on a regular basis or not. So I had determined that Serevent was simply not a good drug.

In the meantime, though, continued taking Flovent (a new drug at that time), which was a much stronger and far more convenient inhaled steroid for me considering I was allowed to take it twice a day, instead of taking Azthmacort (another steroid inhaler) four puffs four times a day. Plus that bulky Azthmacort inhaler was too bulky to carry with me, and I wasn't very compliant with it, which is probably one of the reasons I ended up in the hospital in the first place.

Okay, back to Serevent.

I have an asthmatic friend that I graduated the RT program with, of whom is also currently a fellow RT of mine at Shoreline, and her asthma was so bad she ended up in the hospital three times with severe asthma. It was so bad one time she came close to a vent. It was not pretty.

Five years ago she tried Advair, and it worked like a charm. In fact, she told me it worked so well for her that she almost didn't need to ever use her Ventolin inhaler. Like me, she had been known to sleep with her inhaler in her hand. Not anymore.

Not only does she no longer use her Ventolin, she hasn't been admitted to the hospital, nor even had a small asthma attack in five years. Of course she, like me, makes a gallant effort to stay away from things that trigger her asthma. That, too, is a very important and difficult challenge for us asthmatics.

She recommended that I try this drug, "It's the true miracle drug," she said to me one day. So I tried it again, with the same result, and I quit again. I decided this simply wasn't the medicine for me.

That changed a year ago. I told my doctor that I wanted to try Advair. I took the recommended dose initially, and I again became jittery. So I quit taking it for two weeks. But I was bound and determined that this time I was not going to give up so easily.

I decided to try something different. Something that no expert, and no doctor, and no RT, had ever recommended to me before. Also, I had never read about this in any RT related article nor any blog. This was something I came up with completely on my own. I went against conventional wisdom and decided I was going to wean myself onto this drug, and off my Ventolin at the same time.

So, to start, I took one puff of Advair every other day for a month. At the same time I tried as hard as I could not to use my Ventolin. It was a challenge at times, but so far so good. In the second month, I took a puff of Advair once a day. In the third month I took one puff the first day, and two puffs every other day, and the fourth month I was at the recommended frequency of twice a day; once in the morning and once before bed.

Lo and behold, it worked. By this point, I was able to work a 12 hour shift without using my Albuterol once. And, I find if I do feel short of breath, and I wait a bit, I can feel the Serevent taking effect. In this way, I find I can avoid using my rescue medicine completely.

Keep in mind that I still use my Ventolin, and usually just when I wake up. I'd say, overall, I use it as often as every six hours or sometimes I can go 12 or 16 or even 24 hours without using it. That is a major accomplishment for me, a person who had been addicted to Ventolin (or Alupent before that) for 25 plus years.

I've been doing this for a year now. It works. Advair really works. And if I sound like I'm excited, I am. But not nearly as excited as I was when I was able to also wean myself off of my Theophyln tablets after I had decided I was never, never, never going to be able to do that.

My point here is that Advair, like my fellow RT asthmatic friend told me, really is the "true miracle drug," when it comes to asthma.

The neat thing is, based on my experience here with Advair, I have told this story to some of my co-workers, friends and patients who also have had bad experiences with Advair. I told them not to just start taking it and quit as soon as they get jittery, but to wean themselves onto it like I did.

It's well worth it.

Serevent, or Advair in general, have turned me into a new person. While before a year ago there was no way I could ever leave the house without checking my pocket to make sure I had my rescue inhaler in there, I no longer have to do that.

Likewise, up to a year ago I would have an asthma attack if I forgot to take my theophylin. If I went on vacation without it, I'd be stressed. Not anymore. Now I have weaned myself completely off theophylin. I haven't taken it now in, oh, about two months. (But I'm still not ready to get rid of the full bottle in my medicine cabinet).

And, instead of taking a bunch of different drugs, all I take it Advair, with the occasional puff of Ventolin and that's it. I highly recommend other asthmatics try Advair, and I highly recommend that doctors and RTs teach the weaning onto it method I discovered.

Perhaps I should patent this idea.


Tim Asthma and You said...

great info get more just like this at

Anonymous said...

I am glad you have found some relief with Advair. As an asthma educator, I have to add that if you are still using your rescue inhaler every morning, your asthma is not fully under control according to the GINA guidelines. Hopefully you have done everything possible to limit exposure to potential triggers as well.