N&PD Moderators: Skorpio
Swampfox's Asthma Treatment Thread
Sturnam
Bluelighter
Your resting heart rate is 90 bpm? And from all the stories and posting, you're in the range of 18-21 right? IMO that's part of the issue here, AFAIK a resting heart rate for a 18-25 male should be 50-70 bpm. You might wanna get that checked out.
Lightning-Nl
Bluelighter
The majority of the reason why my resting bpm is 85-90 is because I have asthma. Every morning, I take a long-acting beta2-adrenergic agonist (Salmeterol) in order to keep my lungs free of mucus. A side-effect of that is a higher heart rate. At least, I think anyways....
ebola?
Bluelight Crew
It checks out. High basal anxiety and regular caffeine use are also notorious.
ebola
Lightning-Nl
Bluelighter
Totally forgot about those.
I take a plethora of stimulants everyday (Salmeterol, Albuterol, Amphetamine, and various dosages of Caffeine that rarely go over 100 milligrams though), a calcium/sodium channel blocker (which are pretty well known to fuck with your heart beat), and tend to have a high level of anxiety all the time (many diagnosed anxiety disorders). All these things added together is probably why I have an incredibly difficult time calming down without the assistance of a benzo.
checktest
Bluelighter
Do any of those long-acting beta agonists come with corticosteroids? I imagine they may, as use of solo beta agonists was discouraged due to increasing asthma attack severity.
Just asking as some people can have pretty bad exacerbations of anxiety and other mental illness, as well as develop cushingoid-type conditions and adrenal insufficiency with use. Typically in more heavy, strict corticosteroid use, but poly-drug use can be funny. Read: Prednisone mania and sequelae.
I've been wondering about long term effects of many drugs on gluco- and minerocorticoid receptors, and how that plays into long term effects. Some benzos certainly have effects, and I might guess that various amphetamines may be taxing on that system, even if other neurotoxicity is "accounted for".
Personally, I've been on some pretty good courses of prednisone for an autoimmune rash, and have had some recurrent depression and anxiety that seems to not respond to exercise, therapy, ignoring it, and a decent anti-depressant, so I'm curious.
But yeah, asthma and anxiety isn't great, especially with panic.
TriputoryHeadicine
Bluelighter
Meditation will do the trick. breathwork. You can calm down naturally, I believe in You! : )
Lightning-Nl
Bluelighter
It definitely works... When you aren't taking 5+ stimulants every day. However, taking up to 40 milligrams of Amphetamine, and caffeine, and two beta agonists.......no it really isn't possible.
Trust me, every time I get anxiety I try very hard to stop it without medication. Most of the time I'm able to if I'm not on so many stims. In fact, I can sometimes do it if I haven't had any caffeine that day (in spite of the amphetamine and bronchodilators). But if I'm already on the edge of panicking - the only thing that will terminate it, is a benzodiazepine.
checktest said:
In fact, I am on a steroid. I could lookup the generic name, but I'm feeling lazy - the tradename of it is Advair. It's an inhaled antinflammatory drug for people with Asthma, COPD, etc.
Lightning-Nl
Bluelighter
Also, Montelukast (Singulair) is a stimulant as well apparently. So we can add that to list of stimulants I take on a day-to-day basis.
I'm glad I compiled this list. I should cut a ton of these out. Probably get off of the Singulair and Salmeterol. Especially since I haven't had an asthma attack in a long time. And I have my rescue inhaler (Albuterol) anyways...
MyDoorsAreOpen
Bluelight Crew
SwampFox, just how bad is your asthma? If all you had was your rescue albuterol inhaler, how many times a week would you need to use it? Would you wake up gasping for breath most nights? I ask because a lot of people who go on amphetamines for ADHD and also have asthma, can often cut down -- if not out -- their long-acting beta agonist and/or inhaled steroid. I'm seeing kind of the opposite pattern in your med list.
In any event you have way too much sympathetic tone. Keep this up for years and your cardiovascular health may suffer. I really think getting of the salmeterol, and any oral steroids, is a great goal. If you're using the DXM for tolerance reduction, you might try taking either 30mg with dinner (at which time I assume you don't typically take any stimulants), or 15mg twice daily.
Lightning-Nl
Bluelighter
Interestingly enough - since starting the amps, my asthma has been a lot better. I didn't even think about the Beta agonists or Steroids, because I've been on them my whole life. Anyways, I stopped them yesterday and I really feel no different. I usually have to use my rescue inhaler (on average) once a day anyways, so I'm not sure the Advair was making any difference. The Singulair may have been more for allergies now that I've stopped taking it... Because my has been acting up all day today and the Singulair shut it up.
Also, I noticed potentiation between the Singular and Adderall. The locomotor stimulation of Adderall was greatly increased when administered with Singular (something that I hadn't noticed until just now). That actually makes sense to be honest. Montelukast has indirect effects on Norepinephrine. That would also explain the nasal decongestion I felt from it... Hmm... that makes me wonder why they haven't attempted to replace Sudafed with Montelukast for OTC treatment of nasal decongestion...
Anyways, my Adderall dosage is purely on an "as needed" type deal. I'm allowed to take up to 40 milligrams, IR, throughout the day. Usually I only take up to 30. But due to the fact that the effects of the IR pills, generally only last 4 hours at most - I take the amps pretty much at whatever time I want. In fact, I take them typically in the evening because that's when I need the most energy and focus. Maybe that's not a great idea - but it's what I've been doing. Also, I would take the DXM in the morning hours then - but that's when I take my Lamotrigine and I've notice that if you combine the two - it's a recipe for tachycardia.
Idk...what's your input on that?
Kittycat5
Bluelighter
Please reconsider stopping the Advair. Hell, I may even venture you need to increase to the next higher dose (please do not take extra doses of yours, the salmeterol dose is fixed among the three strengths.). One goal of asthma therapy is to use the rescue inhalers less than twice per week. You said you use daily.
You obviously enjoy pharmacology, but just because a drug has a response does not mean it is effective at treating a disease.
Lightning-Nl
Bluelighter
I've never heard any of that before. Could you explain in a little more detail? Why wouldn't I use my rescue inhaler all the time? And why shouldn't I stop the Advair? I know it's supposed to prevent asthma attacks - but I'm trying to gauge if it's actually been helping or not. So far, there's been no difference in my asthma.
Also I have the yellow tag Advair. I know there is green, yellow, and red. I've been on yellow for a very long time. I don't remember what the numbers inside of the tag are off the top of my head (it's either 250 or 550 I believe).
Kittycat5
Bluelighter
The goals of asthma management is to limit impairment of your functionality due to acute exacerbations and to limit risk that goes with chronic asthma (decreased lung function, hospitalization, further acute attacks). One of the criterion use to measure which stage asthma one suffers and how to change therapy is indeed how frequent you use your SABA. Of course, there are other factors but from what you have posted, I would say you are in the moderate to severe persistent level. In order to control such symptoms you increase doses of corticosteroid, add LABA, add LTR antagonist, or for worse cases go to oral steroids.
Here read this. http://www.nhlbi.nih.gov/guidelines/asthma/asthma_qrg.pdf
I assume you know the salmeterol being fixed in all three doses of Advair. If not, I can explain.
Lightning-Nl
Bluelighter
Alright that makes sense.
So what you're saying is that Salmeterol, and Albuterol - while helpful, are only helpful up to certain dosages. Taking more won't help produce greater, positive effects. But upping the steroids (Fluticasone is what's in Advair), so increasing the dosage of Fluticasone, will increase the anti-inflammatory effects that it has and therefore, decrease the liklihood of breathing problems. Okay - I got that.
What if the steroids don't seem to be helping? And you're only getting a response out of the beta-adrenergic drugs?
Kittycat5
Bluelighter
There are two components of asthma, bronchoconstriction and airway inflammation. You need the steroids for the inflammation and are crucial to stopping further effects of the disease where there is actual remodeling of the airway. You may feel the effects of the SABA as it is responding to your physical symptoms (coughing, wheezing, tightness in chest) but does not mean it is the only component holding the asthma in check. On a personal note, how could you even tell as you have been taking advair for a long time.
MichelJacques
Greenlighter
Sorry to get off topic from the asthma stuff, but this deserves going back to. If caffeine causes you anxiety - which is a relatively common side-effect - why are you using it? It seems like any energy issues should be taken care of with the Adderall. Are you using caffeine to reduce your amp use (to keep amp tolerance down)? Maybe something like modafinil would work better in place of the caffeine?
Also, have you tried other stimulants (ritalin, d-amp)? The l-amp may be adding to anxiety issues (you probably know this, but since I was bringing up the topic anyway).
I'm asking bc as somebody who suffers from anxiety, I don't see how ingesting a substance that can so directly and obviously be connected to increased anxiety would be warranted. In my opinion, the benefit from consuming such an anxiogenic would need to be extremely high to warrant it's use. I'd be surprised if caffeine fits the ticket for that.
ebola?
Bluelight Crew
This might be an obvious point, but how often do you smoke cigarettes on top of the rest of your stimulant cocktail? If it's with any regularity, quitting could reduce your incidence of symptoms and allow for reduced medication dosage.
ebola
Lightning-Nl
Bluelighter
Believe it or not, I smoke a lot less than I'd like too. I bum a cig at work whenever I can, but that's maybe... once every two months? But yeah... nAChrR agonism is a great way to increase heart rate... especially with ACh being the primary neurotransmitter responsible for muscle tissue excitation.
Glad you brought that up actually. I was planning on buying an ecig, but I might reconsider now that I've remembered that Nicotine greatly increases heart rate.
ebola?
Bluelight Crew
If you smoke this infrequently, it's clearly not an issue, and you're right: ownership of an e-cig could lead to increase in sum use of nicotine. I just remember your 'reports' of smoking cigarettes until you felt ill.
ebola
Lightning-Nl
Bluelighter
If you smoke this infrequently, it's clearly not an issue, and you're right: ownership of an e-cig could lead to increase in sum use of nicotine. I just remember your 'reports' of smoking cigarettes until you felt ill.
ebola
Haha, yup! That's why I don't smoke often. Because I always over do it and end up puking my guts out. I remember, specifically, several months ago that I smoked just one whole cigarette on 20 milligrams of Ambien... I puked probably 10 times, then passed out on my bed. Woke up 4 hours later with little recollection of what just happened. Oh and I was covered in vomit.
Since then, I've kind of developed a distaste for cigarettes... I still smoke them whenever I get my hands on some opiates though. I smoked, one time, on 120 milligrams of codeine (no tolerance) and was instantly addicted to that amazing euphoria. Now, if I ever have some 'opies' around - I always make sure to have some cigarettes around too...