anticholinergics

[amber682]

Has anyone here with cf (or a child with cf) ever been prescribed
these? I always thought drying out the mucus was a bad idea. I
thought it was already too dry and that's why so sticky and hard to
move. My son's doc prescribed Duradryl (generic for Extendryl) to
help with his cough, thinks it could be post nasal drip. This med
is a decongestant/ antihistamine/anticholinergic (dries up mucus
secretions). It just sounds like a bad idea.

 

[NoExcuses]

if your son has post nasal drip, he probably has allergies. I would think that treating the underlying cause (allergies) rather than the symptoms (post nasal drip) would be the preferred method.

Try some Zyrtec instead.

 

[Justsmurfin]

I take an inhaled ant-cholinergic. Spiriva. For me it has really helped my lungs and not been drying.

Atrovent in both the nebulizer and nasal spray is drying for me but has never effected me in a bad way.

No experience with an oral one like extendryl

For me Zyrtec was the WORST experience. For some reason Zyrtec dried me out horribly and made my lungs wore. Not to mention made me so sleepy. I just take a steroid nasal spray (for me Nasonex does the best...I've tried Rhincort AQ, Nasacort AQ, Nasonex and Flonas with Nasonex Unscented being the best)

 

[amber682]

I just called the nurse to ask about something else and brought
this up as well. I told her I didn't mean to second guess the dr.
but I was just asking about it. She said their are no stupid
questions and if its keeping me up at night, it needs to keep them
up as well.<img src="i/expressions/face-icon-small-smile.gif" border="0"><br>
<br>
She assured me that cf patients use it all the time and that he
will be fine. They think a lot of this coughing may be coming from
a sinus type thing causing dripping into the back of his throat.
Thanks for your replies because I was a little worried about it. I
figured it would dry up the mucus even more and make it even
stickier and harder to move.

 

[NoExcuses]

yikes.... sounds like she is encouraging u to treat symptoms and not the reason for the dripping.....

 

[NoExcuses]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Justsmurfin</b></i>


For me Zyrtec was the WORST experience. For some reason Zyrtec dried me out horribly and made my lungs wore. Not to mention made me so sleepy. )</end quote></div>

I suggested Zyrtec because it's available in ped form. Allegra doesn't have a suspension for unfortunately.

Everyone's body is different and no drug is a panacia..... for the most part, many tolerate Zyrtec well.

 

[thefrogprincess]

I will only these types of meds when I'm at the end stage of a sinus infection other wise the post nasal drip gets me to coughing and the infection moves in to my lungs anyway. Its happened so many times. Watch him close, if he starts to have labored breathing, wheezing, or anything else worrisome call the doc. And I agree with what the others said about just treating the symptom and not the cause.

 

[amber682]

Amy, I feel like the dr. is grasping at straws trying to figure out
what is up with this cough. They have said he will be hospitalized
if he's not 100% at follow up appt. I don't like the idea either!
He's only been on it for 2 days, and seems a little better, but if
its just treating the symptom, when the med is stopped the problem
would be back right? (Assuming its an allergy) I think they might
just be trying to figure out what is causing the cough, is it
allergies, reflux, or a bacterial infection.<br>
BTW, I have a question for you because you seem to know a lot about
this sort of thing. I know there was a thread about not treating
staph. My son usually cultures it without symptoms. Now he's got
this cough. So the nurse says today that he cultured it last
week(and a month ago) and its very common, found
everywhere, blah blah blah, and they don't treat it unless
it's causing a problem. I'm thinking it could be! Plus she says
don't worry because its very susceptible to most antibiotics. But
now he's cultured it twice on anti's. What's your view on this
one? 

 

[mneville]

Amber, my son Aidan also has cultured Staph pretty much since his
first culture at 1 month old. We do not treat it unless it causes
symptoms. Having said this, he started with a runny nose in October
that continued for months. We tried oral antibiotics, nasal sprays,
allergy meds...Nothing worked. He finally had a CAT scan when it
developed into a nasty cough. It turned out he had Severe sinus
disease, he was hardly breathing through his nose at all.<br>
<br>
A PICC was put in for a month to get rid of the infections. He then
required significant sinus surgery. Since then he is doing really
well. We do nasal rinses once a day followed by Flonase This will
last forever b/c his sinuses seem to be the biggest problem thus
far.<br>
<br>
I feel terrible. He just ate milk and pizza for lunch. We thought
he swallowed all his enzymes but it turns out he didn't. He had the
worst diaper in ages! Total oil and through everything. He was also
complaining of "tight"- we think that means his stomach
hurts.<br>
<br>
Megan

 

[NoExcuses]

Sinus infections can easily result from untreated allergies. CF doesn't help the situation either. This is why it's so important to get allergy tested and to determine why there is post nasal drip (not just treating the symptoms). Sinus infections can lead to worsening lung disease without a doubt.

In terms of treating staph. When a CF patient has PA, you want to make sure you chose an antibiotic that always kills both sets of bacteria. Otherwise, in a patient with PA and Staph, where staph is killed by an antibiotic but not PA, PA will flourish. It is though that Staph keeps PA levels in check.

In terms of a patient with just staph - ya, normal healthy people get bronchitis and pneumonia from the bacteria staph aureus. And if it's causing symptoms, it should be treated. But CF patients will most likely be chronically colonized with bacteria because extra mucus allows for permanent growth. So bottomline if your CF patient doesn't have PA and Staph but just Staph, treat if symptoms persist.

 

[amber682]

He has cultured pseudo once almost a year ago, and not again since.
But I know that doesn't mean it's not there. That's why I kind of
want him to have the bronch if he's admitted, so they can really
get in there and see if that's what the prob is. I don't think
gagging him to make him cough on a swab is not  the greatest
way of seeing what could be growing in there. If they think it's
just allergies, I'd like him to be on something for allergies, not
post nasal drip. I'll ask at next appt. in a week or so. They
seem to think that the wheezing is more from his nose, not his
lungs. From what I gather, they're thinking reflux, allergies, or
maybe something more serious like pseudo again is causing his junky
cough. I'm also going to ask about a mold panel, and if they're
concerned that he hasn't gained any weight over the last 2 mos.,
although he didn't lose weight either.<br>
<br>
Thank you all so much for your opinions on this. He doesn't seem
any better, so I imagine he will be admitted, that's what they told
me.<br>
<br>
Edited to add that they make me feel like "The boy who cried
wolf" because they keep telling me if he's not better in a
week he'll be admitted, so that's what I tell everyone. Then they
change their minds and do another course of meds!