mixing two narcotic medications is never a good idea. take one only when you are in pain (the morphine) and the other when you are experiencing you cold or flu-like symptoms AND pain (the codamal). if you mix the two, you put yourself at risk by subjecting your liver and stomach to all sorts of failures. in no circumstance is it safe to do this

This statement is not true. I take both as well as a whole host of other medications for

Syringomyelia, Chiari Malformation, Hydrocephalus, Gastro-Oesophagael Reflux Disease, Oesophageal Spasms, Oedema, Depression, Hiatus Hernia, Charcot's Joint, Severe Obstructive Sleep Apnoea, Dysphagia, Sinusitis, Photophobia, Sebaceous Cysts, Folliculitis, Acne, Fatigue, Lateral Epicondylitis, Haemorrhoids, Irritable Bowl Syndrome, Dehydration, Dizziness, Vertigo, Atrophy, Paresthesia, Tinnitus, Severe and Chronic Pain, Incontinence, Sunsetting, and various medicated side-effects.

It is important that your pain management is supervised by your GP.

I also have various :-

Allergies:

Penicillin, Alcohol, Fried Food, Acidic Fruit, Peppermint, Sugar, Artificial Sweeteners, Citric Acid, Ascorbic Acid, Acetic Acid, Cow's Milk, Carbonated Drinks, Caffeine, Chocolate, Onions, Garlic, Chilli, Greasy Food, Cabbage, Cauliflower, Broccoli, Brussels Sprouts, Spices, Salt, Pepper, Ginger, Flavourings, Tomatoes, and their derivatives, Paste, Glue, Household/Industrial Cleaning Agents, Strong Aromas, Household Dust and Dust Mites, Dogs, Cats, Perennial Allergic Rhinitis, Asthma.

In my armoury I have :-

Current Medication: Daily Intake

Cetirizine 10mg, Lansoprazole 60mg, Furosemide 80mg, Nedocromil, Beclometasone, Tramadol 300mg, Co-Codamol 8x530mg, Fluoxetine 20mg, Folic Acid 5mg, Sildenafil Citrate, Domperidone 60mg,

Now who said they have had a bad day?

Asthma is a disease of the respiratory system, which causes swelling and narrowing of the airways. Pediatric asthma refers to asthma in children.

Pediatric asthma

This article discusses asthma in children. For a more general discussion about the disease, please see asthma.

Asthma is commonly seen in children. It is a leading cause of hospital stays and school absences. Children with asthma may be able to breathe normally most of the time. When they encounter a substance that can cause problems (a "trigger"), an asthma attack (exacerbation) can occur.

Common asthma triggers include:

• Animals (hair or dander)
• Aspirin and other medications
• Changes in weather (most often cold weather)
• Chemicals in the air or in food
• Dust
• Exercise
• Mold
• Pollen
• Strong emotions
• Tobacco smoke
• Viral infections, such as the common cold

In recent years, there has been a worldwide increase in the number of children with asthma. This trend has been linked to environmental factors, including air pollution. However, it is important to understand that indoor triggers can play just as much of a role as outdoor triggers in bringing on an asthma attack.

Children's airways are narrower than those of adults. This means that triggers that may cause only a slight problem in an adult can create more serious problems in children. In children, an asthma attack can appear suddenly with severe symptoms. For this reason, it is important that asthma be diagnosed and treated correctly. Some children may need to take medicine every day to prevent attacks, even when they do not have symptoms.

• Difficulty breathing
• Fast (rapid) breathing
• Shortness of breath, even at rest
• Tightness in the chest
• Cough

Note: A persistent night-time cough is one common sign of asthma, even in children without other symptoms.

Emergency symptoms:

• Difficulty breathing
• Bluish color to the lips and face
• Severe anxiety due to shortness of breath
• Rapid pulse
• Sweating
• Decreased level of alertness, such as severe drowsiness or confusion

The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.

Tests may include:

• Lung function tests
• Peak flow measurements
• Chest x-ray
• Allergy skin or blood tests
• Arterial blood gas
• Eosinophil count (a type of white blood cell)

You and your child's pediatrician or allergist should work together as a team to create and carry out an asthma action plan. This plan should outline how to

• Avoid asthma triggers
• Monitor symptoms
• Take medicines

The plan should also tell you when to call the nurse or doctor.

You should also have an emergency plan that outlines what to do when your child's asthma flares up. If your child is in school, make sure teachers, school nurses, physical education teachers, and coaches know about your child's need to take asthma medicine. Find out what you need to do to let your child take his medicine during school hours. (You may need to sign a consent form.) Make sure the school has a copy of your child's asthma action plan.

MEDICATIONS

There are two basic kinds of medication for the treatment of asthma:

• Long-term control medications
• Quick relief or "rescue" medications

Long-term control medications are used on a regular basis to prevent asthma symptoms, not for treatment during an attack. They should be taken every day, even when you do not have symptoms. Some people may need more than one long-term control medication.

Types of long-term control medications include:

• Inhaled steroids (such as Azmacort, Vanceril, AeroBid, Flovent) prevent swelling in your airways - these are almost the first choice of treatment
• Leukotriene inhibitors (such as Singulair and Accolate)
• Long-acting bronchodilators (such as Serevent) help open airways - are usually used in combination with inhaled steroids
• Cromolyn sodium (Intal) or nedocromil sodium
• Aminophylline or theophylline (not used as frequently as in the past)

Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:

• Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, Xopenex, and others.
• Corticosteroids, such as prednisone or methylprednisolone) given by mouth or into a vein

Although these are the same medications used to treat adults, there are different inhalers and dosages especially for children. In fact, children often use a nebulizer to take their medicine rather than an inhaler, because it can be difficult for them to use an inhaler properly. Children who use an inhaler should also use a "spacer" device, which helps them to get the medicine into the lung properly.

Children with mild asthma (do not have symptoms very often) may only need quick relief medication as needed. Those who more severe asthma need to take control medications on a regular basis to prevent symptoms.

A child who is having a severe asthma attack should be immediately seen by a doctor. The child may need to stay in the hospital, and may be given oxygen and medicines by an intravenous line (IV).

ELIMINATING TRIGGERS

You and your family can help control a child's asthma by helping get rid of the indoor triggers that make symptoms worse.

If possible, keep pets outdoors, or at least away from the child's bedroom.

No one should smoke in a house or around a child with asthma. Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry smoke residue in and on their clothes and hair -- this can trigger asthma symptoms.

Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms -- this helps reduce the possibility of cockroaches, which can trigger asthma attacks. Bedding can be covered with "allergy proof" polyurethane-coated casings to reduce exposure to dust mites. Detergents and cleaning agents in the home should be unscented.

All of these efforts can make a significant difference to the child with asthma, even though it may not be obvious right away.

KEEPING AN EYE ON YOUR CHILD'S ASTHMA

A peak flow meter is a simple device that you and your child can use at home to monitor lung function. The meter can help you see if an attack is coming, sometimes even before any symptoms appear. This allows you to take preventative measures. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of the child's personal best results mean a moderate asthma attack is occurring or going to occur, while values below 50% suggest a severe attack.

Children under age 5 may not be able to use a peak flow meter well enough to make the numbers useful. An adult should always watch carefully for a child's asthma symptoms. It's a good idea to start using peak flow meters before age 5 to get the child used to them.

With proper treatment and a team approach to managing asthma, most children with asthma can live a normal life. Asthma, however, can be a life-threatening disease. It is important for families to work together with health care professionals to develop a plan to properly care for the child.

The complications of asthma can be severe. Some include:

• Persistent cough
• Lack of sleep due to nighttime symptoms
• Decreased ability to exercise and take part in other activities
• Missed school
• Missed work for parents
• Emergency room visits and hospital stays
• Trouble breathing that requires breathing assistance (ventilator)
• Permanent changes in the function of the lungs
• Death

Call your health care provider if you think that a child has symptoms of asthma. It is very important for asthma to be diagnosed and treated early in order to reduce the risk of complications. If your child is having trouble breathing or having an asthma attack, seek medical attention immediately.

There is no fool-proof method to prevent asthma attacks. The best way to reduce the number of attacks is to eliminate triggers (especially cigarette smoke) and follow the asthma plan that you develop with your doctor. When families take control of their home environment, asthma symptoms and attacks can be significantly decreased.

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.

Szefler SJ. Advances in pediatric asthma in 2009: gaining control of childhood asthma. J Allergy Clin Immunol. 2010 Jan;125(1):69-78.

Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing.

See also: Pediatric asthma

Bronchial asthma; Exercise-induced asthma

Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swell. This reduces the amount of air that can pass by, and can lead to wheezing sounds.

Most people with asthma have wheezing attacks separated by symptom-free periods. Some patients have long-term shortness of breath with episodes of increased shortness of breath. In others, a cough may be the main symptom. Asthma attacks can last minutes to days and can become dangerous if the airflow becomes severely restricted.

In sensitive individuals, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).

Common asthma triggers include:

• Animals (pet hair or dander)
• Dust
• Changes in weather (most often cold weather)
• Chemicals in the air or in food
• Exercise
• Mold
• Pollen
• Respiratory infections, such as the common cold
• Strong emotions (stress)
• Tobacco smoke

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.

Many people with asthma have an individual or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.

• Cough with or without sputum (phlegm) production
• Pulling in of the skin between the ribs when breathing (intercostal retractions)
• Shortness of breath that gets worse with exercise or activity
• Wheezing
  • Comes in episodes
  • May be worse at night or in early morning
  • May go away on its own
  • Gets better when using drugs that open the airways (bronchodilators)
  • Gets worse when breathing in cold air
  • Gets worse with exercise
  • Gets worse with heartburn (reflux)
  • Usually begins suddenly

Emergency symptoms:

• Bluish color to the lips and face
• Decreased level of alertness such as severe drowsiness or confusion, during an asthma attack
• Extreme difficulty breathing
• Rapid pulse
• Severe anxietydue to shortness of breath
• Sweating

Additional symptoms that may be associated with this disease:

• Abnormal breathing pattern --breathing out takes more than twice as long as breathing in
• Breathing temporarily stops
• Chest pain
• Nasal flaring
• Tightness in the chest

Allergy testing may be helpful in identifying allergens in people with persistent asthma. Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas.

The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.

Tests may include:

• Arterial blood gas
• Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
• Chest x-ray
• Lung function tests
• Peak flow measurements

The goal of treatment is to avoid the substances that trigger your symptoms and to control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms.

There are two basic kinds of medication for the treatment of asthma:

• Long-acting medications to prevent attacks
• Quick-relief medications for use during attacks

Long-term control medications are used on a regular basis to prevent attacks, not to treat them. Such medicines include:

• Inhaled corticosteroids (such as Azmacort, Vanceril, AeroBid, Flovent) prevent inflammation
• Leukotriene inhibitors (such as Singulair and Accolate)
• Long-acting bronchodilators (such as Serevent) help open airways
• Omilizumab (Xolair), which blocks a pathway that the immune system uses to trigger asthma symptoms
• Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
• Aminophylline or theophylline (not used as frequently as in the past)
• Sometimes a single medication that combines steroids and bronchodilators are used (Advair, Symbicort)

Quick relief, or rescue, medications are used to relieve symptoms during an attack. These include:

• Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, Xopenex, and others
• Corticosteroids, such as methylprednisolone, may be given directly into a vein (intravenously), during a severe attack, along with other inhaled medications

People with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and, possibly, a hospital stay, oxygen, and medications through a vein (IV).

A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.

The stress caused by illness can often be helped by joining a support group, where members share common experiences and problems.

See: Asthma and allergy - support group

There is no cure for asthma, although symptoms sometimes improve over time. With proper self management and medical treatment, most people with asthma can lead normal lives.

The complications of asthma can be severe. Some include:

• Death
• Decreased ability to exercise and take part in other activities
• Lack of sleep due to nighttime symptoms
• Permanent changes in the function of the lungs
• Persistent cough
• Trouble breathing that requires breathing assistance (ventilator)

Call for an appointment with your health care provider if asthma symptoms develop.

Call your health care provider or go to the emergency room if:

• An asthma attack requires more medication than recommended
• Symptoms get worse or do not improve with treatment
• You have shortness of breath while talking
• Your peak flow measurement is 50-80% of your personal best

Go to the emergency room if:

• Drowsiness or confusion develops
• There is severe shortness of breath at rest
• The peak flow measurement is less than 50% of your personal best
• You have severe chest pain

Asthma symptoms can be substantially reduced by avoiding known triggers and substances that irritate the airways.

Bedding can be covered with "allergy proof" casings to reduce exposure to dust mites. Removing carpets from bedrooms and vacuuming regularly is also helpful. Detergents and cleaning materials in the home should be unscented.

Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms -- this helps reduce the possibility of cockroaches, which can trigger asthma attacks in some people.

If a person is allergic to an animal that cannot be removed from the home, the animal should be kept out of the patient's bedroom. Filtering material can be placed over the heating outlets to trap animal dander.

Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair -- this can trigger asthma symptoms.

Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes, as much as possible.

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publication 08-4051.

Asthma is a disease of the respiratory system, which causes swelling and narrowing of the airways.

This article discusses asthma in children, also called pediatric asthma. For a more general discussion about the disease, please see asthma.

Pediatric asthma; Asthma - pediatric

Asthma is caused by swelling and inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.

Asthma is commonly seen in children. It is a leading cause of hospital stays and school absences. Asthma and allergies often occur together. The allergic response plays a strong role in childhood asthma.

Common asthma triggers include:

• Animals (hair or dander)
• Aspirin and other medications
• Cold air, such as changes in weather (most often cold weather)
• Chemicals in the air or in food
• Dust
• Exercise
• Mold
• Pollen
• Strong emotions
• Tobacco smoke
• Viral infections, such as the common cold

Breathing problems are common. They can include:

• Shortness of breath
• Feeling like you are out of breath
• Gasping for air
• Having trouble breathing out
• Breathing faster than normal

When breathing gets very difficult, the skin of your chest and neck may suck inward.

Other symptoms of asthma in children include:

• Coughing that sometimes wakes the child up at night; it may be the only symptom
• Dark bags under the eyes
• Feeling tired
• Irritability
• Tightness in the chest
• Wheezing, a whistling sound made when breathing, that may be more noticeable when the child breathes out

The type and pattern of your child's asthma symptoms may vary. They may be occur often or only when certain triggers are present. Some children are more likely to have asthma symptoms at night.

The doctor will to listen to the child's lungs. Asthma-related sounds may be heard. However, lung sounds are often normal between asthma episodes.

The doctor will have your child breathe into a device called a peak flow meter. Peak flow meters can tell you and your doctor how well the child can blow air out of the lungs. If the airways are narrow and blocked due to asthma, peak flow values drop.

You and your child will learn to measure peak flow at home.

Tests may include:

• Lung function tests
• Chest x-ray
• Allergy testing
• Eosinophil count (a type of white blood cell)

You and your child's pediatrician or allergist should work together as a team to create and carry out an asthma action plan.

This plan should outline how to

• Avoid asthma triggers
• Monitor symptoms
• Measure peak flow
• Take medicines

The plan should also tell you when to call the nurse or doctor.

You should also have an emergency plan that outlines what to do when your child's asthma flares up. If your child is in school, make sure teachers, school nurses, physical education teachers, and coaches know about your child's need to take asthma medicine. Find out what you need to do to let your child take his medicine during school hours. (You may need to sign a consent form.) Make sure the school has a copy of your child's asthma action plan. See: Asthma and school

MEDICATIONS

There are two basic kinds of medication for the treatment of asthma:

• Long-term control medications
• Quick relief or "rescue" medications

Long-term control medications are taken every day to prevent asthma symptoms, even when your child does not have symptoms. Some children may need more than one long-term control medication.

Types of long-term control medications include:

• Inhaled steroids (such as Azmacort, Vanceril, AeroBid, Flovent) - these are almost the first choice of treatment
• Leukotriene inhibitors (such as Singulair and Accolate)
• Long-acting bronchodilators (such as Serevent) usually used with inhaled steroids
• Cromolyn sodium (Intal) or nedocromil sodium
• Aminophylline or theophylline (not used as frequently as in the past)

See also: Long-term asthma medicines in children

Quick relief, or rescue, medications are used during an attack. Children who not have symptoms very often (mild asthma) may only need quick relief medication as needed. Examples of quick relief medications include: Proventil, Ventolin, Xopenex, and others.

USING AN INHALER

A number of your child's asthma medicines can be taken using an inhaler.

• Children who use an inhaler should also use a "spacer" device, which helps them to get the medicine into the lung properly.
• If your child uses the inhaler wrong way, less medicine gets into the lungs. Have your health care provider show you how to correctly use an inhaler.
• Younger children can use a nebulizer to take their medicine rather than an inhaler. A nebulizer turns asthma medicine into a mist that you breathe in.

ELIMINATING TRIGGERS

It is important to know what things make your child's asthma worse. These are called asthma "triggers." Avoiding them is the first step toward helping your child feeling better.

See: Avoiding asthma triggers

If possible, keep pets outdoors, or at least away from the child's bedroom.

No one should smoke in a house or around a child with asthma. Eliminating tobacco smoke from the home is the single most important thing a family can do to help a child with asthma. Smoking outside the house is not enough. Family members and visitors who smoke carry smoke residue in and on their clothes and hair -- this can trigger asthma symptoms.

Keeping humidity levels low and fixing leaks can reduce growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms -- this helps reduce the possibility of cockroaches, which can trigger asthma attacks. Bedding can be covered with "allergy proof" polyurethane-coated casings to reduce exposure to dust mites. Detergents and cleaning agents in the home should be unscented.

All of these efforts can make a significant difference to the child with asthma, even though it may not be obvious right away.

KEEPING AN EYE ON YOUR CHILD'S ASTHMA

A peak flow meter is a simple device that you and your child can use at home to tell you if an attack is coming, maybe before there are any symptoms. Checking "peak flow" is one of the best ways to control asthma. It can help you keep your child's asthma from getting worse. Asthma attacks do NOT usually come on without warning.

Children under age 5 may not be able to use a peak flow meter well enough to make the numbers useful. An adult should always watch carefully for a child's asthma symptoms. It's a good idea to start using peak flow meters before age 5 to get the child used to them.

See also: How to make peak flow measurements a habit

With proper treatment and a team approach to managing asthma, almost all children with asthma can live a normal life. However, poorly controlled asthma may lead to missed school, problems playing sports, missed work for parents, and multiple visits to the doctor's office and emergency room.

Many times, asthma symptoms occur much less often or disappear as the child gets get older. However, if the child's asthma is not well controlled, it can lead to permanent changes in lung function.

Asthma can rarely be a life-threatening disease. It is important for families to work together with health care professionals to develop a plan to properly care for the child.

The complications of asthma can be severe. Some include:

• Persistent cough
• Lack of sleep due to nighttime symptoms
• Decreased ability to exercise and take part in other activities
• Missed school
• Missed work for parents
• Emergency room visits and hospital stays
• Trouble breathing that requires breathing assistance (ventilator)
• Permanent changes in the function of the lungs
• Death

Call your health care provider if you think that a child has new symptoms of asthma. If your child has been diagnosed with asthma, call the doctor:

• After an emergency room visit
• When peak flow numbers have been getting lower
• When symptoms are more frequent and more severe and your child is following the asthma action plan

If your child is having trouble breathing or having an asthma attack, seek medical attention immediately.

Emergency symptoms include:

• Difficulty breathing
• Bluish color to the lips and face
• Severe anxiety due to shortness of breath
• Rapid pulse
• Sweating
• Decreased level of alertness, such as severe drowsiness or confusion

A child who is having a severe asthma may need to stay in the hospital, and may be given oxygen and medicines through a vein (an intravenous line (IV).

There is no known method to prevent asthma attacks. The best way to reduce the number of attacks is to avoid triggers (especially cigarette smoke) and follow the asthma plan that you develop with your doctor.

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.

Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics. 2009 Mar;123(3):e519-25.

Bush A, Saglani S. Management of severe asthma in children. Lancet. 2010 Sep 4;376(9743):814-25.

Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76.

Review Date: 05/01/2011

Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.