Suggest Treatment For Shortness Of Breath And Anxiety

Posted on Mon, 25 Sep 2017

Question: You have answered a Pulmonary question for me sometime back and it related to shortness of breath. anxiety and niumerous PFT test that are basically normal except for the FEF 25/75. That is not terrible but not great, it responds well to nebulizer but very little to a inhaler. I have been informed that I have no COPD but do have Small Airway Disease, had it since first PFT 17 years ago. Oh I quit smoking in 2000. What might I expect with SAD/, do i just need a good LABA and still to quell the anxiety?

Answered by Dr. Sumanth Amperayani (2 hours later)

Brief Answer:
Suggestions on small airways disease and anxiety

Detailed Answer:
Hi... I understand your concern. I am happy to hear that you do not have any COPD and also that you have quit smoking 17 years back.

Coming to specific small airways disease which you are facing right now, I think your quality of life might improve by using inhaled corticosteroids along with long acting beta agonist.

If I were your physician, I would consider starting a combination of budesonide and formoterol at the lowest dose possible as a metered dose inhaler and follow up. I do not recommend using nebulization at home without supplemented by oxygen.

Coming to the anxiety part, I feel anxiolytics can be used on a daily basis as they do not have any significant interactions with either long acting beta agonists or inhaled corticosteroids.

If you have exercise intolerance, nocturnal cough or sleep disturbance, I feel that inhaled corticosteroids will definitely help improve quality of life a lot.

Regards - Dr. Sumanth

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