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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Asthma. Prescribed Prednisone. Still Have Difficulty Breathing

Hello my name is nick Beckham. I am 24 and have severe asthma . I went to the local ER last night and was diagnosed with a upper respiratory infection and a asthma flair. I was prescribed 80mg of predisone for 5 days but nothing to treat the infection. Since being discharged I have been taking nebulizer treatments with albuterol every 2 hours and adding atrovent every 4 hrs. I am still having difficulty breathing at points in time. And occasionally break out into a sweat. What can I do to relieve the difficulty breathing?
Tue, 12 Feb 2013
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Allergist and Immunologist,  's  Response
Hello,
Thank you for writing to us at Healthcare Magic.

Corticosteroids decrease airway inflammation in acute asthma and prevents late-phase attacks, hence the prednisolone as you well know. 80mg is a big dose, but that depends on body weight and max would be 1mg/kg body weight, so take this after an antacid (such as pantoprazole or rabeprazole) or after a full meal.
That you are continuing to require nebulisers every 4 hours is NOT a good sign, and arterial blood gas tests may be required. So please get yourself seen by your doctor or go to the ER, saying no improvement. I hope an ECG, Chest X Ray was done to ensure there was no other problem, an special tests such as V/Q scan may be required to exclude a lung clot if there is a significant risk (such as a long travel before this acute asthma episode).

Usually long-acting beta 2 agonsits such as salmetrol should be avoided at this stage until you improve.

I hope that was useful.
Best Wishes.
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Have Asthma. Prescribed Prednisone. Still Have Difficulty Breathing

Hello, Thank you for writing to us at Healthcare Magic. Corticosteroids decrease airway inflammation in acute asthma and prevents late-phase attacks, hence the prednisolone as you well know. 80mg is a big dose, but that depends on body weight and max would be 1mg/kg body weight, so take this after an antacid (such as pantoprazole or rabeprazole) or after a full meal. That you are continuing to require nebulisers every 4 hours is NOT a good sign, and arterial blood gas tests may be required. So please get yourself seen by your doctor or go to the ER, saying no improvement. I hope an ECG, Chest X Ray was done to ensure there was no other problem, an special tests such as V/Q scan may be required to exclude a lung clot if there is a significant risk (such as a long travel before this acute asthma episode). Usually long-acting beta 2 agonsits such as salmetrol should be avoided at this stage until you improve. I hope that was useful. Best Wishes.