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I would like to stimulate this conversation. I will return in a few days to offer you my opinion.
Consider listing the medications you take based on the two major categories and the classes of medications. Some medications are available as inhaler and nebulizer, so it would be helpful if you declared which formulation you use in addition to the order that you take them. We are just talking about the inhaled medications, not oral or intravenous medications.
Category 1 – Rescue Medications – These are short-acting agents that last 4-6 hours
Short Acting Beta Agonists – SABA (albuterol, Proair, Proventil, Ventolin, Xopenex)
Short Acting Muscarinic Antagonists – SAMA (ipratropium, Atrovent)
SABA/SAMA (ipratropium/albuterol, Duoneb, Combivent)
Category 2 – Controller Medications – These are long-acting agents that last 12-24 hours
Long Acting Beta Agonists – LABA (Foradil, Serevent, Brovana, Perforomist, Striverdi)
Long Acting Muscarinic Antagonists – LAMA (Spiriva, Tudorza)
Inhaled Corticosteroid – ICS (Qvar, Pulmicort, Flovent, Asmanex, Alvesco)
ICS/LABA (Symbicort, Advair, Dulera, Breo)
I look forward to hearing about your opinions on this. I will give you a hint and state that there is no existing evidence for the preferred order of taking these medications that I am aware of, but there are a bunch of varying professional opinions. Very fun topic to chat about, enjoy.
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