Managing Medication for Respiratory Issues in Seniors: A Guide

Q: Managing Medication for Respiratory Issues in Seniors: A Guide

Hello： Is there a pulmonary function assessment for lung capacity? If there is obstructive lung disease, can inhalers be used instead of oral medication?

Tracheal-related medication consultation?

Hello, my 70-year-old mother, who weighs 78 kg and has not smoked for over 20 years, has been experiencing shortness of breath for the past couple of years.
She gets breathless after climbing three flights of stairs.
Last year, she consulted a cardiologist who said her heart was fine but that her blood was somewhat thick, so he prescribed aspirin and a stomach medication.
This year, she visited a pulmonologist; during her first appointment, the doctor prescribed Xanax and Ventolin.
During her second appointment, the doctor stated that her lungs were fine.
My mother reported that the previous medications caused discomfort in her stomach and chest, and the doctor then prescribed a month's supply of Xanax and another stomach medication, Gastrogel.

I would like to ask if, since both her heart and lungs are deemed healthy, it is necessary for her to continue taking Xanax? My mother is already on medication for hypertension and hyperlipidemia, and I am concerned that she may be taking too many different medications.
I was not able to accompany her to the second appointment, so I am asking here.
Thank you.

Xiao Huai, 40~49 year old female. Ask Date: 2023/06/05

Dr. Wu Yingxun reply Pulmonology

Hello: Is there a pulmonary function assessment for lung capacity? If there is obstructive lung disease, can inhalers be used instead of oral medication?

Reply Date: 2023/06/05

More Info

Managing medication for respiratory issues in seniors can be a complex task, especially when multiple health conditions are involved. In your mother's case, it seems that her respiratory symptoms have been evaluated by both cardiology and pulmonology, with no significant findings in terms of heart or lung disease. However, her ongoing symptoms of shortness of breath and discomfort after taking medications raise important considerations regarding her treatment plan.

Firstly, it is essential to understand that the medications your mother has been prescribed, such as Salmeterol (善寧) and Budesonide (康速龍), are commonly used for managing chronic obstructive pulmonary disease (COPD) or asthma. Salmeterol is a long-acting beta-agonist (LABA) that helps to relax the muscles in the airways, making it easier to breathe. Budesonide is an inhaled corticosteroid that reduces inflammation in the airways. These medications can be beneficial for patients experiencing chronic respiratory symptoms, but they also come with potential side effects, particularly in older adults.

Given that your mother has reported gastrointestinal discomfort after taking these medications, it is crucial to assess whether the benefits of continuing them outweigh the side effects. In older adults, polypharmacy (the concurrent use of multiple medications) is a significant concern, as it increases the risk of adverse drug reactions and interactions. Therefore, it is wise to regularly review her medication regimen with her healthcare providers.

Here are some steps you can take to manage your mother's medication effectively:
1. Medication Review: Schedule an appointment with her primary care physician or a geriatric specialist to review all her medications, including those for hypertension and hyperlipidemia. This review should focus on the necessity of each medication, potential interactions, and side effects.

2. Symptom Monitoring: Keep a detailed record of your mother's symptoms, including when they occur, their severity, and any correlation with her medications. This information can help her healthcare provider make informed decisions about her treatment plan.

3. Consider Non-Pharmacological Approaches: In addition to medications, consider lifestyle modifications that can help manage her respiratory symptoms. These may include pulmonary rehabilitation, breathing exercises, and maintaining a healthy diet. Encouraging her to stay active within her limits can also improve her overall well-being.

4. Educate on Inhaler Technique: Ensure that your mother is using her inhalers correctly. Improper technique can lead to inadequate medication delivery and ineffective symptom control. A respiratory therapist can provide valuable guidance on this.

5. Follow-Up Appointments: Regular follow-up appointments with her healthcare providers are essential to monitor her condition and adjust her treatment plan as necessary. If her symptoms persist or worsen, further evaluation may be warranted, including pulmonary function tests or imaging studies.

6. Discuss Concerns with Healthcare Providers: If you have concerns about the necessity of continuing Salmeterol or any other medication, do not hesitate to discuss these with her healthcare provider. They can provide insights into the rationale behind the prescriptions and whether adjustments are needed.

In conclusion, managing respiratory issues in seniors requires a comprehensive approach that considers the individual's overall health, medication regimen, and lifestyle factors. By actively engaging with her healthcare team and monitoring her symptoms, you can help ensure that your mother receives the most appropriate and effective care for her respiratory needs.

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