instruction: hello doctor my mother is 62 years old she is a diabetic on oh and under good glycemic control she weighs about 56 keg she is suffering from a dry cough for four months now the chest ray is normal and ent consultation also ruled out any local cause she complaints of tickling sensation and coughs following it coughing even wakes her from sleep at night blood investigations done had all findings within normal limits except for high eosinophil count spirometry was done with the following results values pre inhalation are fac 60 47 fev1 63 18 fev1 fac 13 per 68 89 few 25 75 59 25 values after inhalation fac 70 60 fev1 71 72 fev1 fac 10 per 70 few 25 75 54 43 after this the treatment was started with a diagnosis of moderate restrictive and obstructive lung disease she is currently on budamate 200 trans caps one in the morning through lupihaler budate 200 and triohale transcap one cap each through inhaler at night tablet ab phylline one tablet daily at am but her symptoms improve intermittently and again recur spontaneously kindly suggest what to do
output: hello I have seen the put pulmonary function test report of your mother let me tell you first that the put test is not done properly as post test is done immediately only after four minutes of the pre test ideally we do it after 15 minutes so we cannot rely on this put report even if we see at the report it shows moderate obstruction and no bronchodilator reversibility so it goes more in favor of cold chronic obstructive pulmonary disease the treatment of cold is mainly bronchodilator drugs by inhaler route so I suggest to stop budamate budate and triohale rotacaps start foracort inhaler 400 with zerostat spacer two puffs twice daily morning and evening and duova inhaler with spacer two puffs only in the morning continue tablet ab phyllis 200 one tablet daily if she feels too breathless after any type of exertion she can take dublin inhaler by spacer two puffs as required strict sugar control is advised I hope this helps