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Tuesday, October 6, 2015

Asthma Medicine: Home Versus Hospital

The following was originally published on February 16, 2015, at

Asthma Medicine: Home Versus Hospital

The goal of asthma treatment is to prevent and control asthma so you can live a normal life with it. Still, from time to time, some asthmatics require a hospital admission to get their lungs back into shape. When this happens, the medicine you normally take at home may change and be administered in a different fashion than you’re used to.

Here are some changes to expect if you ever require a hospital admission for your asthma.

Controller Medicine. Usually, if you take asthma controller medicine at home (Advair, Dulera, Symbicort, Breo) you will continue to receive the same medicine in the hospital. This is important to note, because it usually takes 2-3 weeks for the medicine to get into your system and start working. Your admitting physician surely won’t want you to start all over once you are discharged.

However, it’s important to understand that the brand used in the hospital may be different from what you use at home. For example, say you take Advair at home. The medicine in this inhaler is similar to the medicine used in Symbicort, Dulera or Breo. The hospital might only carry Symbicort, meaning you may receive a different inhaler while admitted. This is okay.

Now, some asthmatics (like myself) respond well only to a certain brands (in my case Breo), and respond not so well to the other brands. In this case, even if the hospital does not carry your brand, the pharmacist will make a special effort to get the medicine for you. Once you alert your admitting physician, there is no need to worry.

Rescue Medicine. Most asthmatics carry a rescue inhaler (albuterol, xopenex) on them at all times, and use it when they feel asthma symptoms. In the hospital you will not take your rescue medicine on your own, and instead it will be delivered by a Respiratory Therapist (RT).

This is an important change, because most asthmatics are admitted for unstable asthma. An RT can keep a close eye on you during the treatment. If the treatments are not working, the RT might call your physician so you can get the help you need.

Nebulizers before inhalers. Most physicians prefer you do not use your own inhalers in the hospital, and instead rely on the nebulizer brought by the respiratory therapist. There are two very good reasons for this:]
  • Diminished Flow. During an asthma attack, air trapped inside your lungs prevents you from generating enough flow to actuate inhalers. 
  • Longer Duration. Nebulizers allow you to inhale the medicine slowly over a period of five to ten minutes, compared to a single puff of an inhaler. This assures good distribution of the medicine throughout your air passages. 
Feeling better? Once you start to feel better your physician may try to get you back onto your normal routine before you are discharged. At this time you may keep your inhalers at your bedside and use them when you normally do. You may still get breathing treatments when you need them, although you will probably have to call for one and wait for an RT.

Education. A nurse or RT will probably make sure you are well educated about your medicine and how to use it. You may be required to demonstrate proper technique prior to using it on your own. This is all good. It’s an effort to make sure you are doing everything right on your part to keep your asthma under control.

Gallant Asthmatic. Before you are discharged your physician will probably write a prescription for all your home medicines, and this may include some changes from your previous routine. By taking these exactly as prescribed, you should be able to live a normal life with asthma like Jake Gallant.

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