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Suggest Treatment For Shortness Of Breath Despite Having Prednisone For COPD

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Posted on Mon, 19 Jan 2015
Question: I am currently on prednisone treatment for COPD/Emphysema, after my very first exacerbation. scary to say the least. I had severe shortness of breath and a very deep non-productive cough. I was put in the hospital overnight and given high iv doses of prednisone along with several nebulizer treatments and 2-4 liters of oxygen. slightest exertion would cause my breathing to become very labored and my breathing was very deep feeling like I had just ran a marathon. I just couldn't catch my breath. I am feeling a lot better except for a very deep dry non-productive cough which I have had for a few weeks. The symptoms were more prevalent at night with wheezing and waking up every few hours or so. Just started my new oral medication today with the dosage of 40 mg for 2 days, than 30 for 2 days than 20 and so on. I am currently doing nebulizer treatments every 4- hours with a combination of Ipratropium Bromide 0.5 mg/Albuterol Sulfate 3 MG, I was also given a Albuterol 2.5 inhalation solution for the nebulizer, that can be done between the above treatment if needed. I have not yet had to do that treatment as the above is working well. I was also prescribed a Ventolin HFA 90 mcg inhaler to use as needed in between, and finally a cough syrup of Guaifenesin AC that I can take at night if needed . My wheezing has subsided substantially. I have not yet seen a pulmonary doctor yet but my primary doctor is making me an appointment to do that so they can get a base line on the COPD/Emphysema. Like I mentioned above, this is the first time I have ever had any problems with my COPD to this degree and the first time ever that I had to take prednesone. What kind of response or side effects should I expect? this is the 2nd round, I was on the 60, 50 40 30 20 10 series a few weeks ago for the very first time to knock this stuff down. and I was very emotional and anxious, along with getting very warm in the face and neck area. I was told that I can take Benadryl with the prednesone to help with the hot flash like symptoms, so I did do that this morning with my first dose. seems to have helped with those symptoms so far. Is there anything I can do or take for the emotional type symptoms as well?
doctor
Answered by Dr. Ronald Schubert (13 minutes later)
Brief Answer:
Prednisone causing emotional lability

Detailed Answer:
Thanks for contacting HCM with your health care concerns

I am sorry to hear that you had acute exacerbation of COPD/Emphysema. This can be very scary when you can't catch your breath. Your doctor has treated you appropriately with inhalers, nebulizers and with oral steroids. Since starting the steroids you have noticed flushing and increased anxiety. The side effect from steroids or prednisone is very common. The anxiety will resolve once you have completed your course of therapy. In the mean time your doctor has recommended Benadryl to reduce the flushing. If the anxiety is overwhelming then I recommend that you contact your doctor again for additional medication. I would recommend using Atarax or hydroxyzine. This is an anti-histamine very similar to Benadryl but can also treat anxiety. It is non addictive and safe to use with your other medications. Using medications like Xanax are addictive and may cause some respiratory depression which is not a good idea for you.

You also asked what to expect with taking prednisone. In your case a short burst of steroids have no long term effects and what side effects you do have currently will subside when you have completed the medication. For long term use of steroids a person can get diabetes, weight gain and increased appetite. They can also get osteoporosis and dependence on steroids. None of these side effects will give you problems with a 1-2 week dosing of prednisone.

In summary
1. short burst steroids safe
2. Increased anxiety and flushing may need Hydroxyzine to help symptoms
3. Long term use of steroids cause diabetes, weight gain, osteoporosis and dependency on steroids
4. Avoid anti-anxiety medication like Xanax or valium

I hope this answers your question. Please contact HCM again with your health care questions or concerns
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ronald Schubert (31 minutes later)
I wanted to mention that I purchased a SP02/heart rate finger monitor. My levels are staying between 92-96, with a heart rate of between 78-88. I am currently taking it easy and not exerting myself in anyway. Are these levels ok? They say normal is 95-100. Should I be concerned with these readings?
doctor
Answered by Dr. Ronald Schubert (11 minutes later)
Brief Answer:
Normal O2 levels for COPD

Detailed Answer:
Thanks for responding again to HCM. You are currently monitoring your oxygenation levels with a finger monitor. Your levels are staying between 92 and 96. For a person with COPD/Emphysema these are normal levels. If your oxygen levels get below 90 that is not and it may indicate exacerbation of your COPD if it stays below 90.

I am glad to see that you are taking control of your health. I recommend you continue to take your medication as directed. Monitor your heart rate, oxygen levels and perhaps even your blood pressures. Do light exercise like walking. Do the exercise indoors and not outside when the weather is this cold. You can go to the mall and do light walking for 30 minutes. Exercise will help regain your strength and help improve your oxygenation.

Also I recommend yearly flu shot and if not already given a pneumonia shot. Avoid anybody who has a cold or upper respiratory infection symptoms.

In summary
1. Maintain oxygen levels above 90
2. If below 90 may need to be seen by MD
3. Maintain medications
4. Light exercise, walking 30 minutes a day
5. Flu vaccine
6. Pneumonia vaccine
7. Avoid people with upper respiratory symptoms

I hope this answers your question. Please contact HCM again with your health care questions or concerns

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

General & Family Physician

Practicing since :1984

Answered : 2407 Questions

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Suggest Treatment For Shortness Of Breath Despite Having Prednisone For COPD

Brief Answer: Prednisone causing emotional lability Detailed Answer: Thanks for contacting HCM with your health care concerns I am sorry to hear that you had acute exacerbation of COPD/Emphysema. This can be very scary when you can't catch your breath. Your doctor has treated you appropriately with inhalers, nebulizers and with oral steroids. Since starting the steroids you have noticed flushing and increased anxiety. The side effect from steroids or prednisone is very common. The anxiety will resolve once you have completed your course of therapy. In the mean time your doctor has recommended Benadryl to reduce the flushing. If the anxiety is overwhelming then I recommend that you contact your doctor again for additional medication. I would recommend using Atarax or hydroxyzine. This is an anti-histamine very similar to Benadryl but can also treat anxiety. It is non addictive and safe to use with your other medications. Using medications like Xanax are addictive and may cause some respiratory depression which is not a good idea for you. You also asked what to expect with taking prednisone. In your case a short burst of steroids have no long term effects and what side effects you do have currently will subside when you have completed the medication. For long term use of steroids a person can get diabetes, weight gain and increased appetite. They can also get osteoporosis and dependence on steroids. None of these side effects will give you problems with a 1-2 week dosing of prednisone. In summary 1. short burst steroids safe 2. Increased anxiety and flushing may need Hydroxyzine to help symptoms 3. Long term use of steroids cause diabetes, weight gain, osteoporosis and dependency on steroids 4. Avoid anti-anxiety medication like Xanax or valium I hope this answers your question. Please contact HCM again with your health care questions or concerns