Less common but sever conditions related to mould spores such as Acute Broncho Pulmonary Aspergillosis (ABPA is a chronic fungal infection plus allergy in the airways) and Extrinsic Allergic Alveolitis (called Farmer’s Lung) should be considered in patients with asthma like symptoms that do not respond to conventional asthma treatments. Occupational (work related) asthma may occur in bread bakers and alsoafter exposure to isocyanates in spray paint, carpentry wood dust, platinum salts in jewellery workers and animal allergens (in veterinary and animal laboratory workers and fish and shellfish factory workers)
A neb treatment has 2500 mcg of Albuterol, while two puffs of an MDI is 200 mcg of the same medicine. The increase in heart rate often noted with the neb reflects the higher dose. So how do we explain the often reported similar subjective and lung response in patients regardless of delivery method ? I’m not sure, but I wonder if the neb dose could be lowered without sacrificing response for those instances where the MDI is effective. Or approach nebs like we do with an MDI: start with 500 – 1000 mcg, and if desired take a second treatment.
Not always. You will probably take more medicine when you begin treatment to get control of your asthma. After a while, you and your doctor will learn which medicine(s) control your asthma best and how much you need. Once your asthma is well controlled, it may be possible to reduce the amount of medicine you take. The goal of this step-down method is to gain control of your asthma as soon as possible and then control it with as little medicine as possible. Once long-term, anti-inflammatory therapy begins, your doctor will want to monitor you every 1 to 6 months.