tag:blogger.com,1999:blog-7423880838207203660.post4354568819374041747..comments2024-01-10T09:56:49.324-05:00Comments on Respiratory Therapy Cave: Your RT Queries: How do you treat thrush?Rick Freahttp://www.blogger.com/profile/01132949384071592216noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-7423880838207203660.post-45918919252920376022009-11-12T16:34:53.179-05:002009-11-12T16:34:53.179-05:00I'm no medical person or anything, but I think...I'm no medical person or anything, but I think it may be the difference between formoterol and salmeterol that cause this difference in dosing.<br /><br />Since salmeterol takes longer to take effect, it makes it kind of useless as a rescue medication, since it takes 15-20 minutes to start working. Formoterol starts working within 1-3 minutes, making it a lot more appropriate as a rescue med.<br /><br />(From experience, when I started Symbicort, and did my first hit in the doctor's office, I was already feeling different by the time I hit the elevator less than five minutes later! I can't really say anything about Advair, because for the few weeks I was on it, it made me WAY worse so I went back to Symbicort).<br /><br />While I'm not on SMART [the turbohaler deters me from using it in public], I do wonder why it's been approved some places and not others. The extra corticosteroid boost that would accompany the bronchodilator makes a lot of sense if you're using it within the SMART program, to beat down on the extra inflammation present.<br /><br />My doctor gave me the option of doing SMART, which I declined. She did say though, I can be flexible with my Symbicort dose [not going over 8 puffs a day, obvioulsy! :)]<br /><br />However, I don't see it making much of a difference of taking 3-4 puffs at a time [morning/evening] if you're flaring as opposed to taking 2 puffs in the morning and increase throughout the day if you need to. In that regard, it's much more flexible (ex. I've had times where I wake up feeling okay, but by 2 pm I've used my Ventolin a couple times, so at this point I increase my Symbicort and keep it increased for a few days).<br /><br />When I increase my Symbicort, I still find the first day I need my Ventolin more than usual [Now if I start yellow-zoning, for the first 24-48 hours I do Ventolin scheduled every 4 hours, and then PRN if I've improved in the first block of time, then drop my Symbicort back down after a couple days]. I think, for me anyways [and I may be wrong], the extra formoterol just doesn't do much anymore and I'm just bumping up the ICS dosage.<br /><br />What are your thoughts about SMART?kerrihttp://asthmadaytoday.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-583403336998085702009-11-11T20:56:21.709-05:002009-11-11T20:56:21.709-05:00Thanks Kerri. I know Advair should never be taken...Thanks Kerri. I know Advair should never be taken more than twice a day, so I guess I just <i>assumed</i> Symbicort was the same. That's what I get for assuming, hey. However, since the FDA has not approved Symbicort to be used more than twice a day, I imagine that might still be a concern. Thoughts?Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-33202055111121513402009-11-11T20:47:47.384-05:002009-11-11T20:47:47.384-05:00Anyone interested in learning more about the SMART...Anyone interested in learning more about the SMART program can click <a href="http://www.asthmansw.org.au/assets/265/File/onAIR_2007_Issue_5.pdf" rel="nofollow">here</a>.Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-76624138354170406792009-11-11T12:52:49.600-05:002009-11-11T12:52:49.600-05:00Hey Rick,
I LOVE when you do these :). They'r...Hey Rick,<br />I LOVE when you do these :). They're fun to read, especially the silly ones.<br /><br />One thing about Symbicort--while I don't think it's approved in the States, in some places (Britian, Canada), it's approved as the SMART program [Symbicort Maintenance and Reliever Therapy], and can also be used as a rescue inhaler between morning and evening maintenance dosages.<br /><br />Still, no more than 8 puffs a day should ever be used, and of course it's always prescribed by a doctor.kerrihttp://asthmadaytoday.wordpress.comnoreply@blogger.com