How Long Asthalin And Nukast Are To Be Given For Persistent Wheezing?

Posted on Thu, 6 Nov 2014

Question: My son is 3 and 1/2 year old and is suffering from wheezing and this is his first episode. We stay in Tinsukia district of XXXXXXX This problem started two month back when he had acute episode of common cold with bronchitis. As of now cough and running nose has subsided with treatment from ascorile syprus and nukast syprus. But wheezing is persistent which reoccurs as soon as nukast syprus is stopped. For how long do we have to give him asthalin and nukast.

Answered by Dr. Drkaushal85 (27 minutes later)

Brief Answer:
no need to worry. continue same treatment.

Detailed Answer:
Hello dear, thanks for your question on HCM. In my opinion you should get done chest x ray as your son is suffering from chest symptoms since 2 months despite of antibiotics, antihistamines, antiallergics etc.
Many times infection can be a cause or congenital lung anomaly like sequestration also gives similar complains.
So I suggest to rule out these by chest x ray.
If chest x ray is clear than I suggest to start combination of long acting beta 2 aginist (LABA) and inhaled corticosteroids(ICS) in place of simple asthalin.
As asthalin contains levosalbutamol which is short acting and action lasts for only 2-3 hours. So you have to repeat the dose after every 2-3 hours.
And LABA and ICS combination is long acting. Its action lasts for 12 hours. So onlt twice daily dosing is necessary.
By doing this, I think your son will improve in 1 week. If not improved than consult another pediatrician and rule out asthma.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your son. Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Drkaushal85 (7 hours later)

I had given him a short coure of syp prednisone which is a steroid for 1wk .But his symptoms still persistent. Does inhaler will have better effect. More over my son is not very cooperative so how to administer him inhaler. Will using ICS with asthalin will affect his growth.with Nukast episode subsides fully in 20min and does not recur for next 36 hrs then recurs why this is so? Although effect of nukast remain for 24hrs.I staying in XXXXXXX since 2 yrs last yr he fid not had any problem but thid yr this thing is not subsiding.Could it be mold allergy as XXXXXXX is humid place.even I had simlar symptoms along with my son .I took same treatment snd recovered in 1month .but he is not getting rid of these wheezing episodes.

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
yes, it can be due to mould allergy.

Detailed Answer:
Hello dear, thanks for your query.
Honestly speaking I don't prefer asthalin in my patients. As it is short acting, thus frequency of treatment is increased and so side effects like palpitation and sweating increases.
And LABA+ICS combination is safe in children. It will not affect growth of your son.
There are special pediatric inhaler devices available. They have spacer and pediatric mask attached to the inhaler device. And it is very convenient to give.
You can also give this when your son is sleeping.
And once you start ICS and LABA combination with nukast syp, I don't think he will have further attacks.
And even if he has episodes, please get done chest x ray to rule out things I have mentioned in previous answer.
And ICS is far better than oral steroids as side effects are minimal with ICS.
And yes, it can be due to mould allergy. So try to avoid it as much as possible.
Hope I have solved your query. If you don't have further queries, please close the conversation and rate the answer.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju