I take Spiriva Respimat (tiotropium bromide) 2.5 mcg/actuation, and Wixela (fluticasone propionate salmeterol inhalation powder) for my COPD. Is there a sequence I should be taking these meds in? Is there a time frame I should use between the two meds?
Yes, there are. Spiriva® HandiHaler® (tiotropium bromide inhalation powder) is one and Serevent® Inhalation Aerosol (salmeterol xinafoate) another. Each is a bronchodilator and capable of giving good relief of shortness of breath.
If from the lungs, you could be experiencing Spiriva® HandiHaler® (tiotropium bromide inhalation powder) withdrawal symptoms, depending on what type of lung problem was being treated with the Spiriva® HandiHaler® (tiotropium bromide inhalation powder). These symptoms, along with your arms feeling weak and heavy, could all be due to anxiety, but could also be symptoms of more serious disease of the heart or lungs. For that reason, you do need to see your doctor to sort this out.
This would include a long-acting bronchodilator, such as Serevent® Inhalation Aerosol (salmeterol xinafoate), Foradil® Aerolizer™ (formoterol fumarate inhalation powder) or Spiriva® HandiHaler® (tiotropium bromide inhalation powder) along with an inhaled steroid. Another potentially helpful, oral medicine is called theophylline. Your doctor may also want to prescribe this.
You should have your blood oxygen level checked, in case it is low and you would need supplemental oxygen.
Spiriva® HandiHaler® (tiotropium bromide inhalation powder) has a maximum duration of action of about 36 hours. To be safe, you would want to be off the medicine for 48 to 72 hours before the spirometry. It would have been preferable, but not mandatory to do the pulmonary function tests (PFTs) at the time the diagnosis of chronic lung disease was made especially if the diagnosis was unequivocal. The other important question would be, “Why 3 CT scans, presumably of your lungs, in 16 months?
Cause of low DLCO and drop in it from test 1 to test 1? I am currently on tiotropium bromide and salmeterol/fluticasone propionate. My reason for posting this is one doc is pessimistic and the other highly optimistic.
Thank you.
Spiriva contains tiotropium bromide which is an anticholinergic bronchodilator. So, yes, both have action against acetylcholine recptors and both are efefctive bronchodilators. You can take any one of them.
Indacaterol is an ultra-long-acting beta-adrenoceptor agonist. So, it gives bronchodialation for a much longer time. It is a more recent drug so long term efficacy data are not available. However, available data does show a marked benefit in individuals with COPD.
In reality that is the dose exposed to at the skin on the beam side, and the dose decreases with tissue depth as some of the radiation is absorbed at each level as it penetrates tissue and is therefore gone and cannot expose the deeper tissues. Many people don't understand this, but tissues actually absorb radiation, and only a small % of the radiation exits the body to form the image. Say 100% radiation enters the skin, maybe a few percent leaves on the backside.
A quarter grain is a very conservative dose, but I could be more specific if you post the lab work that led to her decision (with reference ranges from your own lab report, please).
"She is also waiting 6 weeks to recheck and then only doing TSH as she says I don't need the T3 and T4 checked anymore since surgery." Six weeks is too long when actively adjusting meds. Four weeks is plenty of time. She's dead wrong about just testing TSH.
i am a non responder,after 2 previous tratments with other interferons,now after having a liver biopsy my dr wants me to go on pegasys with copegus, he wants to prescribe the 180mcg/0.5ml shot along which is prefilled but he wants me to take some of the other prefilled shot which would make it more than the normal 180 mcg. i did not ask him exactly how much it will total cause i have doubts about this,i have never heard of this. and may just stick with the 180 once a week.
Welp...Took my final dose (ledipasvir/sofosbuvir/riba) this morning and gave my 12 week blood draw. We shall see. Doc gave me a realistic 80's % chance of svr given my prior Tx's and the fact I am cirrhotic. I have a better chance than ever before.
Yes, you are being too impatient. The 50 mcg is a starting dose. Dependent on the levels of your biologically active thyroid hormones, Free T3 and Free T4, it may take a while to ramp up your meds to achieve symptom relief. In addition, if your doctor only tests for TSH and medicates accordingly, you may never get there.
I am on Tecfidera 240 mg dose. It just occurred to me I missed the morning dose. I have a call into the specialty pharmacy for direction. I didn't find much on the web except "take it as soon as you remember and if close to your next dose take it then but don't double up". This is the first time I missed since starting therapy last month. I feel terrible. Is this incredibly bad?
Second, the efficacy of azithromycin in a 2 g dose for gonorrhea depends on taking the entire dose at once. Taking a second 1 g dose a day later will be no more effective.
Finally, in the very unlikely chance you also have gonorrhea, 1 g of azithromycin probably would sufficient, over 90% reliable. The higher dose is recommended more as a safety factor, not because it's all that much more effective.
It won't out-right harm you, but Xanax is very addictive and you want to use as little of it as possible.
Cardiologist understandably wants me on the highest dose of carvedilol for maximum benefit but I just cannot take the doses he wants due to extremely low blood pressure 80s/50s, dizziness, weakness. I've been on 6.25 in am and 12.5 in pm and doing just ok physically on these doses.
Well last night I couldn't get my BP up so I only took 6.25 in the pm. I feel so much better today-bp is up and I've got more energy and am much less foggy.
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