Advair Diskus, sometimes referred to as fluticasone and salmeterol oral inhaler, is one of the several products used in the control and prevention of symptoms caused by asthma or ongoing lung disease, including chronic obstructive pulmonary disease-COPD, which includes chronic bronchitis and emphysema. This product is combined with inhaled corticosteroid (ICS) therapy to offer long-term treatment for inflammatory and bronchoconstrictive components of asthma; this combination has been proved better than increasing the dose of ICS not only in the control of asthma but also reducing the frequency and severity of exacerbations. Besides, the combination of salmeterol and ICS therapy offers a superior asthma control than when leukotriene modifiers are added to the latter, which is due to complimentary effects of the drugs when used alongside each other, which also helps reduce chances of adverse effects.
This fact that Advair Diskus contains salmeterol, one of whose active ingredients is LABA, makes it a suitable medication for patients whose symptoms are not adequately controlled on a long-term asthma control medication. Advair Diskus comes in different strengths: 100, 250 and 500 µg of fluticasone and 50 µg of salmeterol.
Content of Advair Diskus
Advair Diskus is a combination of two medications: fluticasone and salmeterol. Fluticasone, which belongs to a class of drugs called corticosteroids, is essential for reducing the inflammation (irritation and swelling) of the air passages in the lungs, which opens them as required for improved breathing. Salmeterol, which belongs to the class of drugs called long-acting beta-agonists/bronchodilators, helps to open airways in the lungs by relaxing the muscles in the walls of air passages, hence making it easier for patients to breathe. Also, due to prolonged bronchodilation, salmeterol makes an excellent choice for relieving nocturnal symptoms and reducing daytime symptoms of chest tightness, shortness of breath, wheeze, and cough.
The combination of the two medications is essential when it comes to decreasing the risk developing serious or even fatal breathing problems associated with asthma, unlike when each class of these medications is used alone. However, it should be noted that the need for such a combination may vary depending on the needs of an individual patient.
Usage, Precautions and Side Effects
Just like any medication, the use of Advair Diskus requires some precautions and knowledge of associated side effects. One of the precautions patients under Advair Diskus medication should observe is ensuring that they regularly use it as this enhances effectiveness. Also, in most cases, Advair Diskus is used for long-term treatment; hence patients should not expect it to work right away, and this makes unsuitable for use to relieve sudden asthma attacks — quick-relief inhalers are available for such cases.
Usage Directions: Advair Diskus Blister With Inhalation Device
This is common, but again, just like for any medicine, a patient should read, and ensure the pharmacist provides the “Patient Information Leaflet and Instructions for Use” before using Advair Diskus. In case a patient is under simultaneous use of multiple inhalers, he/she should always give a span of at least a minute between the use of each; it is advisable to use Advair Diskus medication last. Also, the patient should note that the dosage varies depending on medical condition, age, and response to treatment.
Steps for use:
- The device should be held in a flat and level position, after which the patient uses the mouth to inhale the medication. This is usually done twice daily in a span of 12 hours between usage; hence it is suitably used in the morning and in the evening. Care should be taken so that there is no exhaling into the device.
- There should be no separation of the inhaler from the device, and neither should the patient wash the mouthpiece and/or any part of the device. After use, the device should be closed and safely kept.
- After every use, the patient should rinse his/her mouth with water which should be spit; this helps prevent irritation and yeast infections in the mouth and throat.
Patients should use this medication as regularly and at evenly spaced intervals as possible; this increases its effectiveness. Also, it is necessary that the patients maintains their dosage and consult their doctors before terminating usage. Besides, this medication should not be used alongside other long-acting medications belonging to the class of agonists/bronchodilators.
Patients using quick-relief medications such as albuterol on a regular schedule should change that and instead start using these relievers only as often as needed. Similarly, patients using another type corticosteroid which is administered by mouth, for instance, prednisone, should stop doing so or use it only as directed by their doctors. However, this medication should not be stopped suddenly as this will lead to withdrawal symptoms, most of which are prevented by a gradual lowering of the dosage.
Also, patients should note that they may have to wait up to at least a week for them to experience the full benefit of the Advair Diskus medication. However, it is also important to report to their doctors if their condition persists or deteriorates.
The use of Advair Diskus is not without side effects. The side effects commonly affect the lymphatic, ear, nasal, gastrointestinal, lower respiratory, and chest systems. Patients may thus experience, among other problems, dental discomfort and pain, oral ulcerations, oral discomfort and pain, loss of/unusual taste, pneumonia, muscle stiffness, tightness, and rigidity. Disorders such as bone and cartilage disorders, nasal sinus disorders, disorders of sweat and sebum, and sleep disorders may also occur. Others include compressed nerve syndromes, viral and bacterial infections, viral skin infections, skin flakiness, fluid retention, and acquired ichthyosis. Further, some patients may suffer muscle injuries, fractures, wounds and lacerations, contusions and hematomas, ear signs and symptoms, nasal signs and symptoms, keratitis and conjunctivitis.
However, common side effects include hoarseness, throat irritation, headache, and stomach upset. Patients should be on the lookout so that they can observe and report to their doctor should any of these effects persist or worsen.
Adverse but rare side effects include pneumonia in patients with COPD, immunosuppression, hypercorticism and adrenal suppression, reduction in bone mineral density, growth effects, and glaucoma and cataracts.
The main thing about asthma: how to treat it and when to call an ambulance
Asthma is incurable, appears at any age, can start due to mold in the house and completely changes lives.
What is asthma?
Asthma is a disease in which breathing is difficult due to inflammation in the bronchi. The bronchi are tubes through which air enters the lungs. When the bronchi and smaller bronchioles swell and narrow, the airways do not work and the person begins to choke.
Every 10 seconds in the world someone has an asthma attack. Each such attack can be fatal.
The World Health Organization estimates that 235 million people (or even more) suffer from asthma. And among children, it is generally the most common chronic disease. It is so common that even the problem of overdiagnosis has appeared: even children who do not need treatment are recorded in asthmatics, and this is definitely not conducive to the health of the child.
Where does asthma come from?
Asthma is a heterogeneous disease. This means that she has a lot of reasons, but it’s impossible to single out any major one. Simply put, no one knows exactly where the disease comes from.
The list of demons that cause asthma begins with heredity. This is followed by allergies (it may be genetically linked to asthma, smoking, harmful working or living conditions (with polluted air), some sports or infections (for example, flu).
Some even blame modern purity standards Clean environment and the risk of asthma, but such statements have not yet been proven.
What are the symptoms of asthma?
Asthma is usually recognized by attacks that haunt a person for a period of time. Symptoms of asthma are:
- It is difficult for a person to exhale, so whistling appears when breathing.
- Breathing quickens.
- It becomes difficult to talk.
- In the chest there is a pressing feeling, as if it is compressed.
- A cough appears. Sometimes when coughing leaves clear sputum.
- Sometimes a person takes a characteristic posture, leaning on his hands when he tries to cough. There is even chest pain.
Pressure and pain in the chest, whistling from coughing and breathing, and like glass sputum help to distinguish asthma from other diseases.
But the fact is that there is still obstructive bronchitis - a disease that is similar to asthma, but it is very different and often occurs in children. In addition, not all symptoms can occur simultaneously, asthma is easily confused with other diseases of the respiratory system.
Therefore, with symptoms resembling asthma, you should definitely consult with your doctor and not make a diagnosis yourself. The doctor will conduct a series of tests and uses a spirometer - a special device that will determine the respiratory capacity.
Is it true that this is psychosomatics and everything from nerves?
Not really. Asthma can provoke stress, feelings, depression, strong emotions. In this sense, asthma can with a stretch be called a psychosomatic illness. But asthma triggers are not only mental. And in order to rarely provoke attacks, it is necessary to meet with these triggers less often:
- Allergens. Including animals and even cockroaches.
- Infections and frequent ARVI.
- Smoking, including passive (when smoked nearby, and you only breathe smoke).
- Air pollution (at work or in the city).
- Mold, moisture.
- Some medicines, such as painkillers.
- Sports activities.
- Some smells, even harmless.
I seem to have an asthma attack. What to do?
Try to take a comfortable position while standing (leaning on your arms) or sitting. Try to take even, inhaling and exhaling. The main thing - do not panic.
If this happened for the first time and you have no medication, and the attack does not go away after a couple of minutes, call an ambulance.
If you already had seizures and have medicine, then take it as your doctor taught you. If it doesn't get better after drugs, call an ambulance.
How to cure asthma?
Eliminate the very cause of asthma will not succeed, because no one knows what the cause. All that is available - it is time to prevent attacks or immediately stop them. Every asthma patient should have an inhaler, nebulizer, spacer or inhaler.
All of these devices contain medicines that the doctor selects: inhaled β2-agonists with short-acting or other bronchodilators and anti-inflammatory drugs.
Together with them they use hormonal drugs - glucocorticosteroids, which quickly act on the mucous membranes of the bronchi. If you inhale the medicine deeply, the lumen of the bronchi will become larger, which means that breathing will be restored.
What kind of medicine to buy a specific asthma, only the doctor decides, so we deliberately do not call names and active substances.
The problem is that each type of inhaler, spacer or inhaler must be used correctly, only in this case the medicine reaches the bronchi and helps. Therefore, we must carefully listen to the doctor and train in the use of quick-acting drugs.
If asthma attacks occur twice a week or more often, patients are prescribed corticosteroids in other forms, as well as drugs from other groups.
Are hormones harmful to asthma?
Asthma cannot be cured. It happens that asthmatic children with seizures with time happen less and less. As they say, children "outgrow" the disease. It happens that changes in life reduce the risk of an attack and asthma almost never reminds of itself. But you can not forget about it.
As for hormones, it is a therapy for health reasons. Simply put, they save the sick from death.
Of course, any medication has a side effect, therefore the doctor always deals with the selection of the drug, taking into account many factors. The most common side effects when using hormones for treating asthma are irritation of the mucous membranes and thrush in the mouth (therefore, you should rinse your mouth after using medications).
The use of inhaled hormones can reduce the growth rate of children, but only slightly: 0.5 cm per year compared with peers. This is a side effect, but asthma is much worse.
Why not be afraid of drugs for asthma?
We asked the expert pulmonologist to answer this question.
Anti-asthma drugs are among the safest drugs. The ratio of benefits and harm for them is one of the best among all the drugs that created humanity.
There is a high probability of dying from asthmatic status, but it is completely impossible to imagine death from inhalation of anti-inflammatory hormones.
Vasily Shtabnitsky, pulmonologist of the clinic “Chaika” and associate professor of the National Research Medical University named after N.I. Pirogov
However, according to the doctor, there is still some danger. If for the treatment of asthma to use only salbutamol or any other bronchodilator drug of long or short action, then after a while it will cease to act. And then there will be a severe asthma attack, which will be difficult to stop, as the sensitivity to the drug will be completely different. That is, the risks of therapy are not associated with drugs, but rather with their improper use.
What popular methods treat asthma?
None While we are afraid to use hormones and inhalers, therefore, they invent various means like “put the banks”. Vasily Shtabnitsky gives three tips on how not to do it:
- Do not use for inhalation mineral water. They contain a lot of salts, which are useful if you drink them, but can cause bronchospasm.
- Do not use Miramistin and Chlorhexidine. These tools are completely different. What may be the reaction to inhalation is unknown.
- Do not use essential oils. If the oil gets into the lungs with deep inhalation, and not with aromatherapy, it can even cause pneumonia.
In general, the attacks do not go away, the person feels constantly tired, is depressed, is forced to skip work or study due to frequent visits to the doctor (or healer), colds end in pneumonia, which means that asthma is treated poorly. It is necessary to change the doctor and methods.
Lack of attention to asthma only increases mortality.
You say sport causes asthma. I can not play sports at all?
Sport is not always a trigger attack. Asthma is most often provoked by exercises in cold and humid air, or in poorly ventilated rooms, or where a lot of chlorine is used - in the same pool, for example.
Just pick up a sport and a place that does not bother you to do. If properly used inhalery (for example, before training), then the risk of getting an attack decreases.
What more do asthma patients need to know?
What for the successful treatment of asthma must be controlled.
It will be useful to measure the peak expiratory flow rate - one of the indicators of the function of external respiration. To measure the need to purchase a home peak flow meter. A decrease in peak expiratory flow rate may indicate an imminent exacerbation or loss of asthma control. Vasily Shtabnitsky
Worth a diary. It is necessary to record in it, when and how the attack happened: in the morning or in the evening, after some event or meeting with the trigger. According to this diary, the doctor and the patient are guided during the course of the disease, they understand whether the disease is progressing or, conversely, it is time to switch to easier treatment.
COPD: the downside of smoking!
What is hiding behind a strange name - COPD? The term COPD is not well known to the general public. And, nevertheless, COPD is a common, costly disease with serious health consequences. COPD is one of the leading causes of death, the prevalence of which is increasing worldwide.
So, the term COPD means chronic obstructive pulmonary disease
The word "chronic" means that the disease cannot disappear, the word "obstructive", that it causes a narrowing of the airways, and the word "lungs" emphasizes that the entire respiratory system is affected.
Chronic obstructive pulmonary disease (COPD) is a common disease.
Studies conducted under the auspices of the World Health Organization (WHO) have established average figures for the prevalence of COPD: 9.3 / 1000 among men and 7.3 / 1000 among women. In regions with a very high prevalence of smoking, the incidence of COPD is close to 80-100 / 1000 of the adult population. And the prevalence of COPD is highest in countries where tobacco smoking has entered a way of life. Especially unpleasant is that it is progressing steadily, because it is not easy to treat COPD. Therefore, doctors all over the world say that this disease is easier to prevent, and for this, DO NOT SMOKE!
And what are the causes of COPD?
The cause of chronic obstructive pulmonary disease or COPD is well known.
COPD begins to hurt the people in the airways which get harmful substances. And the most dangerous of these substances is tobacco smoke. Products of burning tobacco, falling into the lungs while smoking, cause chronic inflammation in all parts of the respiratory system. This leads to the development of a large amount of mucus in the bronchi, a painful cough appears, the airways narrow as a result of constant swelling of the walls. The destruction of the biomechanics of breathing, called "air traps", causes destruction of the lung tissue.
As a result, gas exchange is disturbed and there is a painful symptom of the disease - shortness of breath.
In addition to smoking, long-term inhalation of harmful industrial gases or particles can also cause COPD.
And what are the main symptoms of this terrible disease? What you need to pay attention in the first place?
The earliest symptom of COPD is coughing. Cough is almost always combined with exposure to risk factors, the main of which, I repeat, is smoking. Usually, this is a slight cough in the morning with a small amount of mucous sputum. Patients, as a rule, ignore the "small" signs of the disease and do not go to the doctor.
The next symptom following cough is shortness of breath. Shortness of breath occurs much later than the appearance of cough. At first, it is felt only during exercise, previously easily tolerated, and with time and in a state of rest.
Therefore, when there are problems with breathing or a cough that lasts more than a month, it is necessary to consult a doctor. Most people go to the doctor, unfortunately, late, with the appearance of severe shortness of breath, whereas for many years they simply do not take cough or shortness of breath as a manifestation of the disease.
How do doctors diagnose and treat COPD?
If an adult has shortness of breath and cough for more than one month, then he may be suffering from COPD. COPD is diagnosed with a simple test called spirometry. This is a simple and painless study. Remember that it is impossible to get COPD. This disease affects only adults, most of whom are smokers or former smokers. Moreover, any type of smoking, both active and passive smoking, can lead to COPD.
Smoking cessation is the first and mandatory step in a COPD treatment program. And the main method of drug treatment is bronchodilating drugs. It is necessary to take medications only according to the scheme prescribed by the doctor.
Medications can be in different forms:
Yes, doctors cannot completely cure COPD, but they can help reduce the symptoms of the disease. Therefore, if you follow the recommendations of your doctor, then:
- You will be less bothered by shortness of breath.
- You will cough less.
- You will feel better.
- Your mood will rise.
What is the prognosis of specialists regarding COPD? What awaits us next?
The available WHO data allow to conclude that the incidence of COPD increases with age and that the disease prevails in men. COPD is the cause of a significant proportion of visits to the doctor, emergency treatment and hospitalization. According to WHO, in 1990, losses due to disability due to the severity of the disease and premature death took COPD 13th, and by 2020 it is estimated that COPD will take 5th place, surpassing all other respiratory diseases. However, recent research on the introduction of effective programs for the treatment and prevention of COPD indicate positive prospects for patients with COPD and the emergence of hope - the disease can not only be treated, but also prevented!
In Europe, approximately 200–300 thousand people die each year due to COPD.
Data provided by WHO in 1997 indicate that COPD has caused 4.1% of men and 2.4% of women in Europe to die.
The volume of hospitalization services provided to patients with COPD in Europe increases dramatically with age.
COPD is the leading cause of disability among respiratory diseases. In the EU, the annual temporary disability due to COPD is 41,300 days per 100,000 population.
The annual loss of labor productivity in Europe associated with COPD is estimated at 28.5 billion euros.
Chronic obstructive pulmonary disease (COPD) - a life-threatening lung disease that interferes with normal breathing - is more than a smoker's cough.
An estimated 210 million people worldwide suffer from COPD.
In 2005, more than three million people died from COPD, which accounted for 5% of all deaths in the world this year.
Almost 90% of deaths from COPD occur in low- and middle-income countries.
The main cause of COPD is tobacco smoke (as a result of tobacco consumption or inhalation of second-hand tobacco smoke).
Currently, the disease affects men and women almost evenly, in part, due to increased tobacco use among women in high-income countries.
COPD is incurable, but treatment can slow the progression of the disease.
According to forecasts, if measures are not taken to reduce the risk, especially to reduce the exposure to tobacco smoke, the overall mortality from COPD will increase by more than 30% over the next 10 years.