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Child Has Asthma. Now With Cold, Cough, Runny And Blocked Nose. Given Azithromycin, Cough Syrup

Posted on Mon, 13 May 2013

Question: my daughter is 4yrs 9months at present, when she was about 1 and half yrs old a doctor said she had asthma and prescribed Flohale125 (fluticosone)inhaler. We used it for 3months as presribed and discontinued. From that time onward whenever she had cold, cough and we feel she had a breathing problem we used it once or twice. For the last 5 or 6 months she had runny nose and nose block. We consult several paediatrician but there was no improvement. I gave her nasal drops every night for about 1 month and discontinued since 3wks back. Since yesterday she developed prductive coughing and whizing sound while breathing. I gave her Azithromycin susp and cough syrup. I also gave her the flohale inhaler since I feel that she had breathing difficuty. I also applied some mustard oil heated with garlic on her chest and back alongwith some vicks vaporub. I am now praying for some improvements. With all I have done, am I doing it right? Pls suggest a cure.

Answered by Dr. Sanjay Sharma (1 hour later)

Hi Dear ,
Thanks for placing your query through XXXXXXX
I can understand your concerns.
It seems your daughter has asthma & also allergic rhinitis in addition.
Asthma is a disease of the airways, the small tubes which carry air in and out of the lungs
Asthma in kids is very common & though not permanently curable , can be controlled very well & people with asthma lead a normal life as long as they understand about illness, rationale of treatment , correct technique of using inhalers & regular follow up with doctor .
Asthma medicines include-
•A reliever medicine relaxes the airway muscles and makes it easier to breathe when you have asthma symptoms.
•A preventer medicine helps to reduce the inflammation in your airways. It should be taken every day, even when you have no symptoms.
•A combination medication contains both a preventer and a symptom controller in one inhaler.
Flohale inhaler is a preventer and has to be taken regularly on a daily basis. Once stopped it takes about two weeks’ time to be effective on restarting.
Just taking it during cough episodes will not help.
During cough episodes she needs relievers (asthalin/levolin etc) either through inhaler or spacer & relievers acts immediately.
For long term control she will need preventers on a daily basis & relievers as and when needed during cough episodes.
For her nose symptoms she needs long term anti allergic medicines by mouth. Also probably needs an anti-allergic or steroid nasal sprays. For this you need to see an ENT specialist who can confirm the diagnosis of allergic rhinitis & treat accordingly.
You have not mentioned which nose drops were you using ?
Has she been prescribed inhalers & spacer or something called dry powder inhaler(DPI) .If so, please recheck the technique of inhaling meds again with your doctor.
For her current episode she needs relievers (asthalin/levolin or similar medicine) if there is definite wheeze & breathing difficulty.
Garlic & vicks are strong & irritant odours & can make asthma worse. Please stop them.
Azithromycin is an antibiotic which will not help in viral infection.
Viral infections are most common triggers for asthma.
You have not mentioned which cough syrup she is getting ?
Make sure she should not be exposed to cigarette smoke & strong perfumes.
Hope I have answered your query.
In the light of information provided/points raised, you can discuss further with her paediatrician.
If you have any further questions I will be happy to answer.
Wish your daughter a good health..

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sanjay Sharma (12 hours later)

The nasal drops is Otrivin for paediatric and the cough syrup she currently using is Coriminic-T. Whenever she took the cough syrup and other cough syrup, her stools becomes abnormal, somewhat liquid and sometime blackish with loss of appetite. I forgot to mention that last year she was given Ambcet syrup for about a month. It was very effective initially but I discontinued when the medicine become uneffective.

Answered by Dr. Sanjay Sharma (58 minutes later)

Pleased to answer further,

Otrivin pediatric nose drop contains decongestant (that opens nose & breathing becomes easy) & should not be given continuously for more than 5 or 7 days. Prolonged use (1 month in your case) is associated with certain side effects & also causes rebound in nose block on stopping.

Her current syrup Coriminic-T is OK for simple cough & cold, but it does not contain any medicine helpful in asthma.

Ambcet syp was effective last year because it contains cetrizine which is helpful in allergic rhinitis.
It is also possible that she might have been wrongly labelled asthmatic while she might just have allergic rhinitis & common viral coughs & cold.
Asthmatic episodes definitely contains wheeze & show dramatic response to inhaled reliever medicines.

In the light of information provided , you can discuss further with her pediatrician.

If you have any further questions I will be happy to answer.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sanjay Sharma (2 days later)

I have also been thinking that my daughter might have been wrongly labelled asthmatic. She used to get good response from antibiotics; Bactoclav suspension, Azithromycin suspension etc. Now we are giving her Azithromycin suspension and she had improved alot but her partial nose block and sneezing will linger on as happened before. Is it safe to use dry powder inhaler? If so, could you give me some of the brand name? Is it normal that she used to have slight stomach pain followed by excretion of liquid stool when (but not always) she took any cough syrup?
I do not mean to offend the doctors here in my place, but no discussion and clear advice is made with us when we consult them. It is not their fault because they have no time for such discussion when so many patients are waiting in queue. It is mainly due to lack of specialist here in my place.
Your advice have been very helpful to me.
Thank you.

Answered by Dr. Sanjay Sharma (15 minutes later)

Hi,
Nice to know that you benefitted from my explaination , at least you are now more aware about asthma & allergic rhinitis .
Your daughter does not need dry powder inhaler as she is very unlikely to have asthma.
Cough syrups generallly do not cause loose stool & pain but antibiotics often do so by disturbing gut flora.
This side effect of antibiotics is often minimised by simultaneous use of probiotics (a mixture of friendly bacteria).
It was pleasure interacting with you.
Best regards.

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Above answer was peer-reviewed by : Dr. Raju A.T