instruction: hello doctor I am 19 years old and asthmatic I weigh around 56 keg my asthma is not severe and it is seasonal asthma and only happens during season change lately my asthma is not going away I did a myteka and feet course along an antibiotic course I do use ventolin inhaler which gives me relief normally these days when I wake up I feel short of breath again it is not that severe it is like 20 when I am not sick my asthma goes away it does not bother me at all during any physical activities I am a chain smoker and have been smoking for two years yet it never made a problem any suggestions
output: hi I can see that you are worried about your asthma let us start from scratch firstly let us confirm your diagnosis of asthma and because you are having symptoms now it is the best time to perform spirometry secondly for asthma you have to use inhalational medication for at least a year after diagnosis and then we can taper off as you are relieved of symptoms I totally understand this is a long duration but we need the medication for controlling your future symptoms thirdly the medicine ventorlin will provide you immediate relief but it will not prevent further attacks so you need to add inhalational corticosteroids to your medication and last but not least you need to quit smoking you already know the health hazards of smoking and in your case it is worsening your asthma symptoms it will be a difficult job but I can help you with that only if you want I hope this helps poorly controlled asthma due to smoking not taking medicine regularly and not taking inhalational corticosteroids as well spirometry with bronchodilator reversibility testing poorly controlled asthma inhaler formoterol mug budesonide 200 mug with spacer two puffs twice daily and can be taken up to four times daily if required and once exacerbation is over it can be tapered off for a month tablet fexofenadine 120 my once a day for a month quit smoking avoid exposure to allergens per peak expiratory flow rate monitoring follow up with investigations