Aug 8, 2019
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Inhaler spacers should come standard with steroid inhalers
When I suggested it the doctor was like "we normally only prescribe these for kids" bih if I had had one of these to begin with I could have avoided so much gagging and damage to my esophagus from stomach acid. I would never have had to skip doses when I was too nauseous. I don't think I ever will again. That was so absurdly easy with the spacer. I didn't taste a goddamn thing and only had to rinse my mouth once as opposed to fifteen times. Why is this not standard.
Symbicort is the most confusing drug I've ever been prescribed. Like there's no way to confirm if I've actually inhaled anything in the moment, until you feel it actually kick in. Really made me appreciate ventolin's stinkiness
Formoterol is a rapid acting LABA, so you can actually just use budesonide-formoterol (Symbicort) as a rescue inhaler AND as a maintenance inhaler. I guess this is the case outside of the U.S., which I learned in residency. Airsupra (albuterol and budesonide) is not superior, but I guess is GINA indicated as a rescue inhaler whereas Symbicort isn't? I just give people albuterol to start. Then Symbicort for maintenance. But then also tell them they can use Symbicort q4 prn. This is SMART therapy. You can take a maximum of 12 puffs of Symbicort daily
Image source: https://getasthmahelp.org/asthma-management-adults/
Start with albuterol, then add steroid and LABA.
Formoterol is a LABA that has rapid onset, so it can be used as a rescue inhaler (budesonide/fortmorerol = Symbicort).
Under asthma guidelines, SMART therapy is recommended for people with moderate to severe asthma, including children ages 5 and older. In general, SMART therapy is considered an easier treatment plan to follow. SMART therapy may also be considered as an as-needed treatment for mild asthma. Formoterol is a long-acting inhaled medication but it works quickly, similar to quick-relief albuterol. Researchers recently conducted a series of clinical trials called SYGMA (Symbicort Given as Needed in Mild Asthma). The clinical trials found the rate of severe asthma flares in adolescents (ages 12 to 18) and adults with mild asthma was significantly lower when using Symbicort as needed, instead of just a short-acting bronchodilator as needed. Important: SMART therapy for mild asthma is not FDA-approved. Talk with your doctor about whether this may be an option for you or your child. Since it’s not FDA-approved, your health insurance may not cover it.
Source: https://allergyasthmanetwork.org/news/asthma-smart-therapy/
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Budesonide/Formoterol doesn't get enough love, everyone always reps Salbutamol but real ones know Symbicort is where it's at.
Symbicort Commercials with Wolf Episodes
Everyone who said symbicort tastes like ants is WRONG. It tastes like bile