Anti-Asthma Medications: Too Much of a Good Thing?
Dr. Jai Maharaj
Monday, August 18, 2003
Source - Journal of Clinical Investigation
In an unusual paradox, asthmatics that are chronically
treated with bronchodilating beta-agonist medications
such as albuterol, ventolin, and salbutamol may
ultimately develop increased sensitivity to airway
constriction and experience exacerbation of their
condition. A new study by Stephen Liggett and colleagues
at the University of Cincinnati in the August 15, 2003,
issue of the Journal of Clinical Investigation describes
a responsible mechanism for this adverse reaction and
reveals a potential new therapeutic target in the
treatment of asthma.
Inhaled selective beta -agonists are the most widely used
treatment for the acute relief of asthma symptoms.
Administered to asthmatic patients via an inhaler,
nebulizer, in tablet or liquid form, or injection, they
cause airway relaxation and reduced airway responsiveness
to nonspecific contractile stimuli. This is achieved by
drug binding to the beta2-adrenergic receptor (beta2AR).
Despite the ability of these agents to immediately
reverse airway obstruction, there has been ongoing
concern that the use of these drugs may be associated
with harmful outcomes. Some, but not all, studies have
revealed that regular scheduled use (e.g., multiple times
daily, every day) of inhaled beta-agonists has resulted
in a loss of control over the condition, which can
manifest as longer asthmatic attacks and post-treatment
airway hyperresponsiveness.
To date, the evidence has suggested that a
desensitization of the beta2AR is responsible. . . .
[...]
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Mark
> Anti-Asthma Medications: Too Much of a Good Thing?
>
> Monday, August 18, 2003
>
> Source - Journal of Clinical Investigation
>
> In an unusual paradox, asthmatics that are chronically
> treated with bronchodilating beta-agonist medications
> such as albuterol, ventolin, and salbutamol may
> ultimately develop increased sensitivity to airway
> constriction and experience exacerbation of their
> condition.
Not exactly a groundbreaking revelation. It's been known for years
that chronic overuse of bronchodilators can result in a downregulation
of the production of new Beta 2 receptors. That's why recommendations
are in place to medicate persistent asthmatics with leukotriene
modifiers or inhaled corticosteroids, and reserve bronchodilators for
episodic/rescue use.
Duh.
Mark, MD
Richard Friedel
complete failure to understand breathing. When the role of suction
pressure during inhaling for stimulating the diaphragm and the role of
chakras as "representational tools" are taken to heart, everything falls
into place. In short: asthma is most probably caused by western
concepts of breathing. If appropriate pranayama breathing exercises were
employed asthma might be a very minor affair. The chief culprit seems
to be western medicine's dogma about the nose only serving to "warm,
humidify and clean the air". This may possibly disappear soon, because
research on the sniff test reinstates resistance in the nose as having a
useful function. I'd say, do ujjayi and nadi sodhanna exercises to
activate the diaphragm and the asthma is likely to go away - providing
the diaphragm obliges. Keep clear of western asthma drugs as far as
possible. Richard Friedel
cindi...@earthlink.net
>Not exactly a groundbreaking revelation. It's been known for years
>that chronic overuse of bronchodilators can result in a downregulation
>of the production of new Beta 2 receptors. That's why recommendations
>are in place to medicate persistent asthmatics with leukotriene
>modifiers or inhaled corticosteroids, and reserve bronchodilators for
>episodic/rescue use.
>Duh.
>Mark, MD
Is that the reason I have 2 inhalers, one that I use every 12 hours no
matter how I feel (Serevent diskus) and one that I use only when I am
in an active attack (albuterol)?
Cindi
Arrhae
"cindi...@earthlink.net" <cindi...@earthlink.net> wrote:
> Is that the reason I have 2 inhalers, one that I use every 12 hours no
> matter how I feel (Serevent diskus) and one that I use only when I am
> in an active attack (albuterol)?
Isn't the manufacturer of Serevent recommending you not use it unless you're
also taking a steroid, now that they've found out it can sometimes make
things worse?
Mark
Precisely...except that Serevent (salmeterol) is actually a
long-acting Beta-2 agonist and is neither a steroid nor a leukotriene
modifier. I personally don't prescribe salmeterol to my asthmatic
patients; I prefer the steroids and/or LMs for the "controller" role.
Mark, MD
Circe
news:5ee850fe.03102...@posting.google.com...
> > matter how I feel (Serevent diskus) and one that I use only when I am
> > in an active attack (albuterol)?
>
> long-acting Beta-2 agonist and is neither a steroid nor a leukotriene
> modifier. I personally don't prescribe salmeterol to my asthmatic
> patients; I prefer the steroids and/or LMs for the "controller" role.
>
was using Serevent alone when I felt things getting a bit out of hand rather
than a steroid. I chose that for reasons I won't go into, but I'm now
reasonably convinced that the use of the Serevent exacerbated the situation
for me when I had the serious attack because I was resistant to the
albuterol as a result of taking it.
Suffice it to say that I haven't had a single asthma attack since I was
released from the hospital on July 11, so the Advair is working very well
for me. I *do* have a bit of concern about possible albuterol resistance
from the Serevent component, and that's something I plan to discuss with my
pulmonologist the next time I see him.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [19mo] mom)
This week's special at the English Language Butcher Shop:
"Use repeatedly for severe damage." -- Directions on shampoo bottle
Daddy: You're up with the chickens this morning.
Aurora: No, I'm up with my dolls!
All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman
>
> Mark, MD
Mark
As I understand it, the down-regulation of the Beta receptors is a
short lived problem once you quit using Beta agonists too much.
For my money, inhaled steroids are the best way to go for long-term
"controller"-type medicines for asthma. The actual absorbed dose for
most of them is miniscule, so the concern about so-called steroid side
effects is really non-existent. According to the data (sorry, no
ready reference at hand), the amount of systemically absorbed steroids
from one 5-day burst of prednisone is the same as that absorbed by
taking twice-daily puffs of inhaled steroids for about 200 years. Not
a bad trade-off.
Sorry to hear about your awful experience, but I'm glad to hear that
the Advair is helping. Anecdotally, I have a good friend who swears
his life was saved by Advair...long story, but he had a similar
experience and is now VERY happy that three years of Advair has
produced zero asthma attacks.
Mark, MD
CBI
"Mark" <mlo...@bellsouth.net> wrote in message
news:5ee850fe.03102...@posting.google.com...
>
> As I understand it, the down-regulation of the Beta receptors is a
> short lived problem once you quit using Beta agonists too much.
>
Well yes, but as long as you are still using the Serevent you haven't quit.
--
CBI, MD
Michael Halliwell
<snip>
> I *do* have a bit of concern about possible albuterol resistance
> from the Serevent component, and that's something I plan to discuss with
my
> pulmonologist the next time I see him.
It is a wise concern to have. In my case, my Advair (more specifically the
Serevent component) does reduce the effectiveness of the albuterol. Because
I'm active, I use the albuterol as a pre-exercise medication to keep the
exacerbation down...problem is that if I catch a snoot full of cigarette
smoke during the day, the albuterol doesn't have enough left to keep me
clear.
Rather than a trip to the ER, I've been set-up with a neb and a
atrovent/albuterol combo to overcome the problem.
It works, but isn't the most ideal.
Just thought I'd putin my $0.02 worth,
Michael Halliwell
--
***************************************
Michael Halliwell
templ...@shaw.nospam.ca
To Reply: remove the "nospam"
***************************************
cindi...@earthlink.net
wrote:
>Isn't the manufacturer of Serevent recommending you not use it unless you're
>also taking a steroid, now that they've found out it can sometimes make
>things worse?
I haven't heard anything about that - I'll have to ask my dr about it
the next time I have to go in.
Cindi
CBI
"Arrhae" <sha...@sympatico.ca> wrote in message
news:BBC483C3.53F5%sha...@sympatico.ca...
I don't think so. They have always promoted it as steroid sparing and
suggested that docs should add their product rather than increase the dose
of steroid. I don't think I have ever heard them comment on just using the
Serevent - probably because it would not be a good idea but they don't want
to say anything that could dissuade use of their drug.
--
CBI, MD
chrissie
> "controller"-type medicines for asthma. The actual absorbed dose for
> most of them is miniscule, so the concern about so-called steroid side
> effects is really non-existent. According to the data (sorry, no
> ready reference at hand), the amount of systemically absorbed steroids
> from one 5-day burst of prednisone is the same as that absorbed by
> taking twice-daily puffs of inhaled steroids for about 200 years. Not
> a bad trade-off.
>
that some of the inhaled steroid become systemic, in quantities that
can cause side-effects.
For example, when my son was a toddler and suffering from severe
asthma, he was switched from Becotide to Flixotide - then a very new
drug - because of concerns about his growth being retarded because of
steroids - the Flixotide supposedly had less systemic effect than
Becotide (due to the different doses).
I myself take a high dose of Flixotide (2000mcg per day) and my
consultant reckons that it will be very hard for me to lose weight on
that dose.
Does anyone have any more information about this?
Regards
Chrissie
Mark
And that is just what I told her: salmeterol is a beta agonist and if
she quits using it, the receptors come back.
Mark, MD
Mark
I'm not familiar with the two drugs you mentioned, but the data from
growth studies do not apparently support the fears of growth
restriction, at least WRT the inhaled corticosteroids used in children
in the U.S.
The essence of the concern is this: patients who used one of the
older inhaled steroids were studied because of the theoretical concern
that long-term use might lead to growth restriction, as we already
knew long term use of oral steroids can do.
It was noted that over years of high-dose use of this product, there
WAS growth restriction: the kids were about 1/2 cm shorter than their
matched peers. (For those using English units, that's about 1/5".)
Subsequent inhaled steroids are absorbed even less than the older
ones, resulting in little to no discernable change in growth.
Moreover, even if the kids in the older study did lose 1/2 cm in
height, their growth velocity increased when they stopped taking the
steroids, and they regained the height they had "lost".
The most important point, though, is this: In the worst case
scenario, your child might lose 1/2 cm in height...would you rather
have that or a child who is at significantly higher risk of a life
threatening asthma attack due to being treated with the wrong
medicine?
Remember, there are about 5,000 asthma-related deaths in the U.S. each
year. 1/3 occur in those who had previously been categorized as
"severe" asthmatics. 1/3 were "moderate" and 1/3 were previously
considered "mild" asthmatics. You don't have to have a history of
severe asthma attacks in order to have a fatal one.
Mark, MD
Richard Friedel
Is this really a responsible attitude?
The cause of asthma is not known. The extensive use of symptomatics does
not seem to be balanced by sufficient basic research. It seems quite
likely that asthma is a functional disorder which becomes extremely
difficult to reverse, see comments on damage to muscles due to attacks
in Chest 1992, pages 1357-61.
The situation in sports is grotesque with a 80% + diagnosis rate
(whatever this means) in some disciplines. It is revolting to think of,
say, figure skating being done by pharmamonsters. It would be better
to switch over to robots or to Steven Spielberg at once.
Forget the drug company shareholders for a bit and try to get some
logical research done.
Your argument, not to say fear mongering, about the primacy of
medication justified by danger of attacks only holds good if you ignore
techniques like that described by Professor Hillsman
onhttp://www.ohiou.edu/isarp/conf_00/ind_papr.htm or properly performed
pursed lips breathing.
For practical purposes I find the following technique quite sufficient
to keep on the good side of my asthmatic tendency without the need of
any medication whatever.
It is based on the thought that asthma involves hectic breathing which
fails to comply with the time constants of lung deflation and inflation.
If one can time one's breathing at will, an attack would seem to be
impossible.
Forcing the breathing rate to stay normal seems to be too difficult for
most patients even if they were properly motivated.
Step-synchronized breathing offers a solution because locomotion
(walking, running) "entrains" breathing as a scientific effect. It is
comparatively easy to keep breathing regular if you take f. i. 3 steps
to an inhale and 3 to an exhale.
With such practice the exhale may extended more and more easily. An
attack is prevented if the exhale can be lengthened.
Extending the number of steps per exhale and inhale to say 8 and 4 is
also healthy for the reason of there being an incentive spirometer (like
a Volldyne) effect improving the vital capacity. See material on
"breathwalking" and "yoga walking" as healthy exercise. Richard Friedel.
cindi...@earthlink.net
>I don't think so. They have always promoted it as steroid sparing and
>suggested that docs should add their product rather than increase the dose
>of steroid. I don't think I have ever heard them comment on just using the
>Serevent - probably because it would not be a good idea but they don't want
>to say anything that could dissuade use of their drug.
My doctor does not have me on a steroid, either inhaled or oral, at
all, but I am taking the Serevent diskus one puff two times a day,
along with an albuterol inhaler as needed, and clarinex once a day for
my allergies. Should I also be on a steroid, either inhaled or oral.
Cindi
cindi...@earthlink.net
>Precisely...except that Serevent (salmeterol) is actually a
>long-acting Beta-2 agonist and is neither a steroid nor a leukotriene
>modifier. I personally don't prescribe salmeterol to my asthmatic
>patients; I prefer the steroids and/or LMs for the "controller" role.
>
>
>Mark, MD
Can you please tell me what exactly a leukotrine (? on spelling)
modifier is and what it does?
Cindi
cindi...@earthlink.net
>Precisely...except that Serevent (salmeterol) is actually a
>long-acting Beta-2 agonist and is neither a steroid nor a leukotriene
>modifier. I personally don't prescribe salmeterol to my asthmatic
>patients; I prefer the steroids and/or LMs for the "controller" role.
>Mark, MD
Also, I have high blood pressure and am lisinopril with hctz. Is a
long-acting Beta-2 agonist appropriate for use by asthmatics with
blood pressure problems?
Cindi
CBI
news:2uboqvku0i36bfa5u...@4ax.com...
>
> Also, I have high blood pressure and am lisinopril with hctz. Is a
> long-acting Beta-2 agonist appropriate for use by asthmatics with
> blood pressure problems?
At normal doses it shouldn't be a problem. At high doses the beta agonists
can stimulate the heart and cause rapid heart rates but, presumably, in this
situation you need them to keep you breathing.
--
CBI, MD
Mark
It's not good for an asthmatic to take a Beta-blocker. Blocking the
Beta receptors is the antithesis of Beta agonism (asthma treatment).
Lucky for you, lisinopril is an ACE inhibitor, and not in the same
class as propranolol or other Beta-blocker antihypertensives.
Are you trying to trip me up? You're coming up with an awful lot of
"interesting" questions...
Mark, MD
B-Ob1
CBI wrote:
CINDI...lets start from scratch here: Age: Weight: Heigth, fat content??
SMOKER??? General diet??? etc...SOMETHINg is causing a possible
COPD syndrome??
You probably need AMINO Acid therapy/INPUT??
Lets get on the black board and outline your physical self before we can
isolate
or round up the herd of problems causing your condition? B-0b1
Richard Friedel
> cindi...@earthlink.net wrote in message news:<2uboqvku0i36bfa5u...@4ax.com>...
>
>>On 29 Oct 2003 11:17:34 -0800, mlo...@bellsouth.net (Mark) wrote:
>
> Are you trying to trip me up?
................
>
> Mark, MD
Fair enough.
Let's stick to the thread title.
1) History may be repeating itself. We do know of the outrageous
behavior of the pharmaceuticals industry prior to the Pure Food and
Drugs Act. See "Gullible America" with Google. The industry was
perverse, was substantially interested in getting patients addicted to
alcohol and narcotics, which were unobtrusively smuggled into the
nostrums. The Act did not really bell the cat.
2) Extreme sporting activities would seem to indicate that the
accompanying maximum breathing rates cause asthma. This would seem to be
a matter of common sense. Abnormal stresses, like months of violent
exercise, on the body are likely to produce pathological conditions,
especially if the mechanisms are obscure and the process goes unnoticed.
3) The pharmaceuticals industry's activities involving dosing the
affected athletes with asthma meds and then winning sympathy for
"asthmatics" (whatever that may mean here) by saying that even the
handicapped can reach top sporting performances, are based on a lie.
4) So its seems logical to see if dysfunctional breathing is not the
underlying cause of asthma and the inflammation of the airways is not
just a result of it, an interpretation which is of course grist to the
mills of the industry.
5) Around this time of the year with temperatures near freezing I do
find that the cold air cuts my breath away. However if I very carefully
breathe from the diaphragm ("yogi complete breath") and synchronize my
breathing to walking (see four steps on and inhale and six to an exhale)
breathing is at first cramped but my breath is not cut off. Walking
makes it much easier to keep breathing properly timed.
6) It therefore seems that asthma is caused by some subtle dysfunction
in breathing, maybe breathing too hectically and not diaphragmatically
so that the bronchi are overloaded. We do know that airways are liable
to collapse (f. i. coughing) but this remains invisible.
It would therefore seem that "anti-asthma medications" (symptomatics)
are not only "too much of a good thing" but possibly the worst possible
remedy in the long run, because they encourage dysfunctional breathing.
Richard Friedel
Mark
> Mark wrote:
> > cindi...@earthlink.net wrote in message news:<2uboqvku0i36bfa5u...@4ax.com>...
> >
> >>On 29 Oct 2003 11:17:34 -0800, mlo...@bellsouth.net (Mark) wrote:
> .......
> >
> > Are you trying to trip me up?
>
> ................
> >
> > Mark, MD
>
> Fair enough.
>
> Let's stick to the thread title.
>
> 6) It therefore seems that asthma is caused by some subtle dysfunction
> in breathing, maybe breathing too hectically and not diaphragmatically
> so that the bronchi are overloaded. We do know that airways are liable
> to collapse (f. i. coughing) but this remains invisible.
>
> It would therefore seem that "anti-asthma medications" (symptomatics)
> are not only "too much of a good thing" but possibly the worst possible
> remedy in the long run, because they encourage dysfunctional breathing.
> Richard Friedel
Asthma and dysfunctional breathing are two entirely separate things.
Both are real, and both can cause respiratory distress, but that's
about all they have in common.
Histopathologic evidence and clinical response to various medicines
clearly define asthma as a problem involving the small airways,
whereas dysfunctional breathing (e.g. vocal cord dysfunction) involves
large airways, the chest wall and muscles.
Mark, MD
Richard Friedel
A Google search with
"cause of asthma" unknown
will show that the cause is unknown. You cannot say "asthma is not
dysfunctional breathing" or if you do, then this is part of a flawed
hypothesis.
See Am J Respir Crit Care Med. 2002 Sep 15;166(6):878-82.
"Racing Alaskan sled dogs as a model of "ski asthma"". Davis et al.
It seems fair to conclude from the abstract that asthma can be a result
of abnormal breathing in some winter sports.
This means that competitors are being encouraged to make themselves ill
with a disease that is often said to be incurable. The percentage of
them developing asthma in the sport is much higher than the percentage
of asthmatics in the normal population.
People like you seem hardly to make anymore sense than the nostrum
vendors 100 year ago.
See "The quack and the dead
"Gullible America," Adams began his first article, "will spend this year
[1905] some seventy-five millions of dollars in the purchase of patent
medicines. In consideration of this sum it will swallow huge quantities
of alcohol, an appalling amount of opiates and narcotics, a wide
assortment of varied drugs ranging from powerful and dangerous heart
depressants to insidious liver stimulants; and, far in excess of all
other ingredients, undiluted fraud."
(http://www.mc.vanderbilt.edu/biolib/hc/nostrums/nostrums.html)
Bottom line is surely that far more attention should be paid to asthma
as being a functional disorder, which may possibly not be completely
reversible but is highly amenable to methods such as pursed lips
breathing if properly performed. See also f. i. Professor Deane
Hillsman of UCLA, "THE RESCUE BREATHING PATTERN"
"http://www.ohiou.edu/isarp/conf_00/papr_19.htm
Professor Hillsman shows how an asthmatic faced with an attack can stop
it if he succeeds in prolonging the exhale for around 8 breaths. This
is for many a small price to pay for freedom from asthma medication.
He should however obviously take vigorous action to improve his lung
function, for example with exercise and avoiding breathing which causes
wheezing or which damages the bronchi. Richard Friedel
Richard Friedel
>> Asthma and dysfunctional breathing are two entirely separate things.
>> Both are real, and both can cause respiratory distress, but that's
>> about all they have in common.
>> Mark, MD
Just where did you get that from? Professor Hillsman (see last posting)
speaks of the particular pattern of breathing during an attack, which
has to be overcome and which is not normal. You are simply splitting
hairs if you believe that a patient should restrain from using a
non-drug tactic to overcome extreme distress because it is has nothing
to do with real asthma. Your symptomatics have much, much less to do
with "real asthma".
Asthma drugs seem to be changing their face so much that they might be
treated as if they were narcotics. Keep to the gist of anti-narcotics
laws.
Your style of arguing makes "alternative medicine" sound more logical.
Who wants this?
Happy Oyster
>Richard Friedel <s3e...@mailin.lrz-muenchen.de> wrote in message news:<3FACA671...@mailin.lrz-muenchen.de>...
>> Mark wrote:
[...]
>Asthma and dysfunctional breathing are two entirely separate things.
>Both are real, and both can cause respiratory distress, but that's
>about all they have in common.
>
>Histopathologic evidence and clinical response to various medicines
>clearly define asthma as a problem involving the small airways,
>whereas dysfunctional breathing (e.g. vocal cord dysfunction) involves
>large airways, the chest wall and muscles.
Perhaps, dear Mr. Mark, you would understand the situation better if
you knew that Richard Friedel already showed up in
de.alt.naturheilkunde and got a severe bashing because of his complete
nonsense.
Richard Friedel jumps through the forums in the net, and all the time
he ends up the same way ...
Regards,
Aribert Deckers
--
The big "gmt"-scam
Circe
news:4eboqvsmst1vgjhu4...@4ax.com...
> My doctor does not have me on a steroid, either inhaled or oral, at
> all, but I am taking the Serevent diskus one puff two times a day,
> along with an albuterol inhaler as needed, and clarinex once a day for
> my allergies. Should I also be on a steroid, either inhaled or oral.
>
you are not treating the underlying inflammatory response and because you
are becoming resistant to the bronchodilators, you run the risk of that
albuterol won't be sufficient to treat a truly serious asthma attack.
Don't wind up like I did--in cardiac arrest. I do NOT recommend it. I have
not had a single asthma attack since I left the hospital on July 11 of this
year--before that, when I was taking Serevent and albuterol, I was up 3-5
nights per week as a result of asthma. The difference is phenomenal. I'm on
Advair now, but will be discussing going to Flovent alone when I next see my
pulmonologist since I am increasingly suspicious of Serevent as a long-term
treatment.
--
Be well, Barbara
(Julian [6], Aurora [4], and Vernon's [20mo] mom)
This week's special at the English Language Butcher Shop:
"Rejuvinate your skin." -- Hydroderm ad
cindi...@earthlink.net
>At normal doses it shouldn't be a problem. At high doses the beta agonists
>can stimulate the heart and cause rapid heart rates but, presumably, in this
>situation you need them to keep you breathing.
I use 1 puff of the Serevent Diskus two times daily (50mcg per puff),
and my lisino-hctz dose is 1 pill (20mg lisino and 25mg hctz) daily.
Cindi
cindi...@earthlink.net
> CINDI...lets start from scratch here: Age: Weight: Heigth, fat content??
> SMOKER??? General diet??? etc...SOMETHINg is causing a possible
> COPD syndrome??
> You probably need AMINO Acid therapy/INPUT??
> Lets get on the black board and outline your physical self before we can
>isolate
> or round up the herd of problems causing your condition? B-0b1
OK:
age - 40
weight -180lbs
height - 5'4"
non-smoker but live with 2 long-time smokers
allergic to cat hairs and live with a cat, but cat stays out of my
room.
had respiratory problems repeatedly as a child but was never diagnosed
as asthmatic until 5 years ago after I caught a terrible cold and the
cough just wouldn't go away.
hypertension runs in my family but I was not diagnosed until pregnant
with my first child, then it got to normal after delivery. same thing
happened after my second child, but didn't get back to normal
work as a room attendant at a major hotel chain, so I am constantly
exposed to chemicals when I am doing rooms, lint and such when I am
doing laundry.
cindi...@earthlink.net
>It's not good for an asthmatic to take a Beta-blocker. Blocking the
>Beta receptors is the antithesis of Beta agonism (asthma treatment).
>Lucky for you, lisinopril is an ACE inhibitor, and not in the same
>class as propranolol or other Beta-blocker antihypertensives.
>Are you trying to trip me up? You're coming up with an awful lot of
>"interesting" questions...
>Mark, MD
No, Mark, not trying to trip you up or anything. Just that most times
if I have a question about my meds or something, I don't have time to
call my Dr as it is way after office hours when I get home. I just
love the fact that I have so many knowledgeable participants in this
group who are actually willing to help out people.
Cindi
B-Ob1
cindi...@earthlink.net wrote:
SMOKING and COPD are virtual TWINS where DEATH is concerned.
You've made tyour OWN BAD BED by buying and smokiing DEATH
in a carton! B-0b1
B-Ob1
cindi...@earthlink.net wrote:
the "PUFF" method is just another way to the cemetary...IF those who
smoke and have smoked and have been gifted with the painful results
would get ther acts together and quit adding to pollution wher other
innocents
are breathing their second hand DEATH! ( articularly children) the
world
air (oxygen) supply just might last till "D" DAY! in 3034. However
it is a
KNOWN fact from our present ability to time travel that we have even
less
time than we had supposed knowing the absolute yeasr that the SUN will
finally no longer be ameliorable. 2nd Peter chapter 3 verse 10 was no
accident!
That whole part of the Bible including rvelatios was written by an
ALIEN about
1300 yrs ago! ( trying to tell even Jewish types like myself that
something is happening!! )
PROPHECY is for everyone!! This coming Dec 03 MAY be a part of it???
B-0b1
ARoberts
> That whole part of the Bible including rvelatios was written by an
> ALIEN about
> 1300 yrs ago! ( trying to tell even Jewish types like myself that
> something is happening!! )
Wow, they had problems with the INS back then too...
peter
2003/Nov/15 cindi...@earthlink.net WROTE
No, Mark, not trying to trip you up or anything. Just that most times
if I have a question about my meds or something, I don't have time to
call my Dr as it is way after office hours when I get home.
Cindi
SPAM COP KATHY
1. BS
2. BS SHIT
3. GET A CELL PHONE YOU DUM SOB BTH
Carey Gregoryy
peter you hit the hammer right on the nail amen
>PETERDUN COPY AND POSTED
>
>Re: Anti-Asthma Medications: Too Much of a Good Thing?
>2003/Nov/15 cindi...@earthlink.net WROTE
>
>No, Mark, not trying to trip you up or anything. Just that most times
>if I have a question about my meds or something, I don't have time to
>call my Dr as it is way after office hours when I get home.
Richard
>PETERDUN COPY AND POSTED
>
>Re: Anti-Asthma Medications: Too Much of a Good Thing?
>2003/Nov/15 cindi...@earthlink.net WROTE
>
>No, Mark, not trying to trip you up or anything. Just that most times
>if I have a question about my meds or something, I don't have time to
>call my Dr as it is way after office hours when I get home.
mkaw
>Re: Anti-Asthma Medications: Too Much of a Good Thing?
>2003/Nov/15 cindi...@earthlink.net WROTE
>
>No, Mark, not trying to trip you up or anything. Just that most times
>if I have a question about my meds or something, I don't have time to
>call my Dr as it is way after office hours when I get home.
Steve Harris sbharris@ROMAN9.netcom.com
COMMENT:
Cindi,
A major side effect of lisinopril-class drugs (called ACE inhibitors)
is cough, which can be difficult to distinguish from symptomatic
asthma. And which can add to asthmatic cough already present. It's
probably caused by proinflammatory substances called bradykinins
produced by the drug in the lungs. Some people get this side effect
(up to 20% of normals), and some don't. The problem is that's it's
very difficult to tell. The effect can also take weeks to come on, and
weeks to clear up after you stop the drug, so it's very sneaky. I can
testify to this.
There are lots of other classes of effective antihypertensives. If you
cough, go to your doc and demand a change. Even if you don't, you
might think about a long course on another drug, just to see what
happens. These days lisinopril is claimed to be safe for asthma, but
the truth is that the objective airway obstruction data on ACE
inhibitors and asthma are conflicting-- some studies find no effect,
but others do. In the early days, a lot of wheezing as well as cough
was reported as ACE inhibitor side effect. I hardly think that this
has somehow magically gone away as the drugs became more widely used.
All in all, risking something that *may* make your symptoms worse
seems a silly thing to do, especially if you have alternatives.
SBH
Tsu Dho Nimh
>age - 40
>weight -180lbs
>height - 5'4"
>non-smoker but live with 2 long-time smokers
You are living with people whose addicitons are harming you.
If they really loved you, they would quit.
>allergic to cat hairs and live with a cat, but cat stays out of my
>room.
You need maximum allergen removal programs throughout the
house. Animal dander is very mobile.
>work as a room attendant at a major hotel chain, so I am constantly
>exposed to chemicals when I am doing rooms, lint and such when I am
>doing laundry.
Consider a change of jobs.
Tsu Dho Nimh
--
When businesses invoke the "protection of consumers," it's a lot like
politicians invoking morality and children - grab your wallet and/or
your kid and run for your life.