Top 3 Treatments For Asthma That Are Not Medication
What is Vicks VapoRub?
Vicks VapoRub is a combination product that is applied to the skin.
When applied to the chest, inhaling the vapors of this product may provide temporary relief of cough caused by irritation of the throat or lungs.
When applied to other areas of the body, this product is used for temporary relief of minor muscle or joint pain.
Vicks VapoRub may also be used for purposes not listed in this medication guide.
Warnings
Follow all directions on the label and package. Use exactly as directed.
Before taking this medicine
Ask a doctor or pharmacist if Vicks VapoRub is safe to use if you have:
a cough with mucus; or
a cough caused by smoking, asthma or emphysema.
Do not use this medicine on a child younger than 2 years old.
Ask a doctor before using this medicine if you are pregnant or breastfeeding.
Avoid breastfeeding a baby while using this product on your chest.
How should I use Vicks VapoRub?
Use exactly as directed on the label, or as prescribed by your doctor.
Do not take by mouth. Topical medicine is for use only on the skin. Do not apply to broken skin or an open wound.
This product can cause a mild cooling or burning sensation wherever it is applied. If this sensation is painful or causes severe discomfort, wash the treated skin area with soap and cool water.
Do not heat the product before use or it may cause burns.
To relieve cough, apply a thick layer of this product to the chest and throat up to 3 times per day. Do not use in your nose or mouth. To make the vapors easier to breathe in, keep the treated areas uncovered or covered only with loose clothing.
To relieve muscle or joint pain, apply this product to the affected area 3 or 4 times per day.
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You may cover treated skin areas with a warm and dry cloth. Applying heat may worsen the sensation of cooling or burning. Do not apply a tight bandage over treated skin.
Call your doctor if your symptoms do not improve after 7 days, or if you have a fever, rash, or headaches.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Since camphor, eucalyptus, and menthol is used when needed, it does not have a dosing schedule. Do not use the product more often than directed on the label.
What happens if I overdose?
An overdose of this product is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the product.
What should I avoid while using Vicks VapoRub?
Do not get this product in your eyes. If contact does occur, rinse with water.
Vicks VapoRub side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Less serious side effects may be more likely, and you may have none at all.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Vicks VapoRub side effects (more detail)
What other drugs will affect Vicks VapoRub?
Medicine used on the skin is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.
More about Vicks VapoRub (camphor / eucalyptus / menthol topical)
Side Effects
En Español
Drug class: topical rubefacient
Patient resources
Other brands
Avedana Medicated Chest Rub
Related treatment guides
Cold Symptoms
Further information
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
There are a lot of cold and flu meds on the market. Some work pretty well; others, not so much. And most have side effects, even when taken short-term. That’s why it’s usually a good bet to start with home remedies, which often provide relief and tend to be safer than drugs.
Understanding Asthma: Mild, Moderate, and Severe
Aches and Fever
OTC DRUGS
Acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve)
HOW EFFECTIVE ARE THEY? All ease body aches and fever.
WHAT ARE THE RISKS? Acetaminophen is safe when used as directed, but taking even a little more than the daily max can harm the liver. The other drugs-nonsteroidal anti-inflammatories, or NSAIDS-can cause intestinal bleeding and increase the risk of heart attack and kidney damage.
WHAT THEY CAN INTERACT WITH-Acetaminophin plus alcohol can threaten the liver. NSAIDS increase the risk of bleeding when taken with a blood thinner such as warfarin (Coumadin) or clopidogrel (Plavix).
HOME REMEDIES
A cool compress or sponge bath-Either measure can help some if a temperature spikes and you don’t have acetaminophen or other fever medication in your medicine cabinet. And note that it is okay to let a fever run its course if it stays under 101° F. That’s because the high temperature is part of the body’s efforts to kill off the offending germs.
Congestion
OTC DRUGS
Oxymetazoline nasal spray (Afrin, Dristan Mucinex Sinus-Max Nasal Spray)
Phenylephrine (Equate Congestion Suphedrine PE Nasal Decongestant, Sudafed PE Congestion)
Pseudoephedrine (Sudafed 12 hour)
Camphor, eucalyptus, or menthol rubs (Mentholatum, Vicks VapoRub)
HOW EFFECTIVE THEY? The sprays work within minutes, faster than pills. Topicals can improve the flow of air through your nasal passages.
WHAT ARE THE RISKS? Topicals can irritate the skin. Sprays can worsen stuffiness if taken for longer than three days. Oral meds can raise blood pressure; cause insomnia, heartbeat abnormalities, tremors, anxiety, and hallucinations; and worsen glaucoma, thyroid disease, and symptoms of an enlarged prostate.
WHAT THEY CAN INTERACT WITH- Oral drugs combined with older antidepressants such as isocarboxazid (Marplan) and tranylcypromine (Parnate) make side effects much more likely, and they should not be taken together.
HOME REMEDIES
Chicken soup-Modern science provides some backup for chicken soup’s reputation for easing congestion, coughs, and sore throats. Research suggests that it may inhibit the buildup of neutrophils, white blood cells that trigger the body’s inflammatory response and contribute to the aches and pains that accompany a cold and the flu. And the hot liquid and steam from any soup that’s mostly broth may help more directly, by opening up swollen airways and thinning mucus.
Neti pots-Nasal irrigation-a saltwater rinse for your nasal passages-eases congestion from allergies and could help when it stems from a cold or the flu, too. There are two main forms: One squeezes saline into the nostrils from a squeeze bottle or bulb syringe. The other-a teapot-shaped device called a neti-pot-uses gravity: Tilt your head sideways, then pour saline into the upper nostril; the liquid flows into one nasal cavity and out the other. To be safe, make sure you use distilled water or water that has been boiled, then cooled, and clean the device with distilled or boiled water after each use as well.
Steam inhalation-Warm water vapor may help loosen mucus. Though it’s unclear whether that translates into reduced congestion, many people swear by it. Showering may be safer than putting your head over a piping hot pot of water, which could scald.
Cool-mist humidifiers-The FDA says these devices can help shrink swelling in nasal passages and allow easier breathing. And the humidity can make it more difficult for flu viruses to survive. Just make sure to keep the device clean.
Cough
How to Relieve Asthma | Reflexology
OTC DRUGS
Dextromethorphan (Robitussin Long-Acting Cough Gels, Vicks DayQuil Cough)
Guaifenesin (Mucinex 12 Hour, Tab Tussin)
Topical rubs, patches, and lozenges that contain camphor or menthol (Halls Menthol Cough Drops, Mentholatum, Vicks VapoRub)
HOW EFFECTIVE ARE THEY? Guaifenesin, an expectorant, thins mucus, making coughs more productive. Dextromethorphan, a suppressant, blocks the cough reflex. Vapors from topicals can feel soothing. But it’s unclear whether any cough drug reduces episodes of coughing.
WHAT ARE THE RISKS? Topicals can trigger rashes and a burning sensation. Oral drugs can lead to nausea and make you sleepy. High doses of dextromethorphan can cause rapid heartbeat, loss of coordination, and hallucinations.
WHAT THEY CAN INTERACT WITH-Cough suppressants can cause increased sedation when taken with narcotics, sleeping pills, some antihistamines, or alcohol.
HOME REMEDIES
Honey-It tastes good and feels soothing, and a 2014 review suggest that it’s better than a placebo at easing coughs. Add a teaspoon or two to a cup of tea or consume it straight off the spoon. And don’t worry: A little extra sugar when you’re sick won’t harm you. But one caution: Honey can contain the bacterium Clostridium botulinum, which in rare cases can damage muscles and nerves in babies. So don’t give it to infants younger than a year old.
Runny Nose and Sneezing
OTC DRUGS
Antihistamines, such as cetirizine (Zyrtec), chlorpheniramine (Aller-Chlor), diphenhydramine (Benadryl Allergy), fexofenadine (Allegra), and loratadine (Alavert, Claritin)
HOW EFFECTIVE ARE THEY? Very, when symptoms stem from allergies, but a 2015 review of 18 trials concluded that the drugs have little benefit when symptoms are from a cold.
WHAT ARE THE RISKS? Drowsiness, nausea, blurred vision, and difficulty urinating, and, with diphenhydramine, impaired coordination.
WHAT THEY CAN INTERACT WITH-Taking chlorpheniramine or diphenhydramine with narcotics, sleeping pills, or alcohol makes sedation more likely. Taking cetirizine, fexofenadine, or loratadine with certain antifungals or antibiotics increases the risk of side effects. Antacids with aluminum or magnesium, and grapefruit and certain other juices can make fexofenadine less effective.
HOME REMEDIES
Honestly, there’s not much you can do besides stocking up on tissues. But note that a runny nose and sneezing help rid your body of germs. If you find yourself without a tissue in hand, sneeze into your elbow so that the germs don’t end up across the room infecting an innocent bystander.
Sore Throat
OTC DRUGS
How does asthma work? - Christopher E. Gaw
Pain relievers such as acetaminiphen (Tylenol), ibuprofen (Advil), and naproxen (Aleve)
Benzocaine (Cepacol Extra Strength Sore Throat Sugar Free, Chloraseptic Warming Sore Throat Lozenges)
Dyclonine (Sucrets Sore Throat Lozenges)
Menthol (Halls Triple Action Soothing Drops, Vicks VapoDrops)
Phenol (Chloraseptic Sore Throat Spray)
HOW EFFECTIVE ARE THEY? Pain relievers help. Benzocaine, dyclonine, and phenol work as local anesthetics, and menthol provides a cooling sensation in your throat. Medicated lozenges may work longer than the sprays.
WHAT ARE THE RISKS? High doses of benzocaine and dyclonine might in rare cases cause lightheadedness, shortness of breath, fatigue, or rapid heart rate. For the risks of pain relievers, see OTC drugs for aches and fever.
WHAT THEY CAN INTERACT WITH-None known for phenol or benzocaine lozenges. Menthol drops make bleeding more likely with warfarin. For pain relievers, see drugs for aches and fever.
HOME REMEDIES
Gargling with salt water-It’s inexpensive, safe, and time-tested. Dissolve 1/2 to 1 teaspoon of salt into an 8-ounce glass of warm water, gargle in the back of the throat, then spit. Repeat a few times a day.
NOTE: This article appeared in the January 2018 issue of Consumer Reports. Editor’s Note: Most drugs listed throughout this report are also available as lower-cost generic or store brands. The listed drugs are examples and are often multisymptom products that contain several active ingredients.
Find out why asthma symptoms might happen at night, what you should do about them, and when to see your GP or asthma nurse.
On this page:
Why is my asthma keeping me awake?
What should I do when my asthma wakes me up?
How to prevent asthma symptoms at night
When to see your GP or asthma nurse
Tips from other people with asthma
Why is asthma keeping me awake?
It’s common for asthma symptoms to come on at night, but you shouldn’t have to put up with them. Night-time asthma symptoms are a sign that your asthma isn’t well controlled, and you may be at risk of an asthma attack.
If your symptoms come on early in the morning, it could be a sign your asthma has been difficult through the night, even if you weren’t aware of it.
Does Vicks Vapor Rub Help With Asthma?
Here are some reasons why your symptoms may come on at night:
How you sleep - lying on your back puts extra pressure on your chest and lungs. This makes it harder to breathe. It can also trigger a cough because mucus in your nose can drip to the back of your throat. If you get acid reflux lying flat might make it worse, and the acid can irritate your airways. Propping yourself up with pillows can help to keep your airways open.
Side effects - some asthma medicines give you night-time side effects. Medicines like montelukast can cause sleep issues (in up to 1 in 100 people). Steroid tablets may also cause difficulty sleeping, so you may be advised to take them after food in the morning.
Triggers - you may find asthma triggers in the bedroom. For example, dust mites in your mattress, pillows and blankets, and pet hair and mould. If you are affected by hay fever, you may find pollen affects you at night because pollen levels are highest in the early morning and early evening.
Hot or cold air – breathing in hot air can cause the airways to narrow, so if your room is hot at night, try using a fan to keep cool. Cold air might also be triggering your symptoms. Try keeping windows closed and keep heating on low in the bedroom if you need to.
There is also evidence to suggest that a lack of sleep can make your asthma symptoms worse. If you’re struggling with sleep and it’s affecting your asthma, speak to your GP or asthma nurse.
What should I do when my asthma symptoms wake me up?
Sit up and take your reliever inhaler (usually blue) as prescribed. It’s a good idea to keep your inhaler and spacer (if you use one) beside your bed before you go to sleep, so you don’t have to search for them in the middle of the night.
“Give yourself a bit of time to check your reliever medicine has dealt with your symptoms before you go back to sleep,” says Dr Andy Whittamore, Asthma UK's in-house GP. “This is better than falling asleep straight away only to wake up soon after with asthma symptoms because your reliever didn’t help enough.”
People with asthma might experience stress and anxiety when feeling breathless at night. Some people find breathing exercises are beneficial when experiencing anxiety and panic.
5 Surprising Things That Can Trigger Asthma Attacks
Asthma and your sleep
Dr. Andy Whittamore explains why you should book an appointment with your GP if your asthma is keeping you awake at night.
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Video: Asthma and your sleepDr. Andy Whittamore explains why you should book an appointment with your GP if your asthma is keeping you awake at night.
Transcript for Asthma and your sleep
How to prevent asthma symptoms at night
Using your preventer inhaler every day, as prescribed, will build up protection in your airways and keep your asthma symptoms under control, so they’re less likely to wake you at night.
It’s very important to:
use your written asthma action plan to help you understand how to manage your symptoms and what to do if they get worse.
go for regular asthma reviews with your GP or asthma nurse. They can check you’re using your inhalers correctly. It’s also a chance to talk about any triggers that might be affecting your sleep.
Does your child wake up at night from asthma symptoms? Read our advice on asthma and your child’s sleep.
When to see your GP or asthma nurse
Visit your GP or asthma nurse
Book a next-day appointment with your GP or asthma nurse if you are experiencing asthma symptoms at night or when you first wake up.
Tips from other people with asthma
If your asthma is keeping you awake at night, you’re not alone. Here are some of the things that people with asthma tell us help them get a good night’s sleep:
Try a nasal spray or decongestants to unblock a stuffy nose (but test this out during the day first - some people find decongestant products containing eucalyptus trigger their asthma symptoms).
Keep as active as you can in the day to increase your lung strength and boost your immune system. Ask your GP or asthma nurse if you need support with exercise.
Try using anti-allergy bedding covers and keep pets away from the bedroom.
Try using an air purifier to help with allergy symptoms that trigger your asthma.
Avoid any food or drink asthma triggers close to bedtime, such as caffeine and alcohol.
Relax and de-stress before bed using breathing exercises and yoga.
Obstructive sleep apnoea is a breathing problem that happens when you sleep. If you’re looking for advice on OSA, our sister charity the British Lung Foundation has more information.
Is It Ok To Use Vicks Rub On A 4year Old Child That Has Asthma?
Is it all right to use Vicks Vaporub on a 4-year-old child who has asthma?
Asthma Symptoms: What Causes Asthma Attacks?
Answer
Vicks Vaporub is a topical medicine designed to relieve cough in cases of the flu and colds. It is considered safe for kids age 2 years and older, provided you follow the package directions carefully. However, Vicks will not relieve an asthma cough in a child with asthma.
It is important NOT to rely on over the counter formulas such as Vicks to treat asthma. It could be used as a supplemental treatment, I suppose, though I would encourage you to discuss that with your child's doctor. But for effective asthma treatment, your child will need to be taking an inhaled steroid of some type. That is the only way to achieve reliable and consistent asthma control, especially during times of illness, and will keep your child healthy.
Has anyone else experienced their child developing respiratory difficulties after using vicks vapor rub on them? My 13 month old has never had any of these symptoms until yesterday when I had to take him to hospital because of wheezing / coughing! I had rubbed vicks onto his chest several times over 3 days to try to relieve his blocked nose.
He's been prescribed an inhaler that I have to give him 6 puffs 4 times a day. Of course I didnt think to mention the vicks while at hospital.
The other possibility is that he has actually developed asthma, there's no way of knowing until later on. Im really worried about him, ive got no experience with this kind of condition. Any input would be great.
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Add message | Report | See allHuffymuffy Fri 18-Feb-11 13:46:26
I am fairly sure you shouldn't use Vicks on under twos. I could be wrong, but I have always bought the special one for children it has an orange flash on the label and don't use it on their chests just on their feet with socks on top.
But I do prefer Olbas for children. Check with NHS direct.
Add message | Report | See allPixieOnaLeaf Fri 18-Feb-11 15:30:46
Message withdrawn
Add message | Report | See allWomblingWriggles Fri 18-Feb-11 17:23:31
I can't use either of those products without them setting off my asthma. so definitely could be the cause of the problem.
Add message | Report | See allmaxybrown Fri 18-Feb-11 19:11:31
yes I think it says on it - I remember having trouble getting one for DS when he was little - Boots own is from 3 months and def not as strong as Vicks, I had it on myself last nigth and could hardly tell hmm
Add message | Report | See allmaxybrown Fri 18-Feb-11 19:12:24
here's the info on it for you smile
Add message | ReportPumpkinBeans Fri 18-Feb-11 20:21:19
Thanks for the input, it said 6 months up on the jar but on the website says 2 yrs?!
His breathing hasn't really changed but I took him back to see our GP who advised to keep on with the 6 puffs. I suppose if it is the vicks that has caused the problem it will take a few days for his body to right itself.
This is so horrible, ive put years on worrying about his breathing! I keep thinking he's just going to stop suddenly or something.
His cough is bad too, sounds like he needs to bring a lot of stuff up. Dr said no chest infection though. I've got to stay calm about it, I suppose if he's been like this for 36 hrs and is still ok there is no reason why he would suddenly go downhill!
Confirming the Diagnosis of Asthma
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Add message | Report | See allmaxybrown Fri 18-Feb-11 20:38:31
awww pumpkin don't worry - I would contact vicks too if it says that on the jar?
My DS is same at the minute, no chest infection but cough sounds horrific - like an old man needing to spit into a bucket, ewwwwww!
Keep him with you, make you feel better smile
Add message | ReportPumpkinBeans Fri 18-Feb-11 21:15:21
Yes, I will keep him in with me. He's just fallen asleep & his breathing has slowed a little. Will give him his puffs now.
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Add message | Report | See allmaxybrown Fri 18-Feb-11 21:20:35
ahhhhh bless him, hope your night goes ok smile
Add message | Report | See allbumble34 Sat 19-Feb-11 09:11:50
far more likely that the virus that was causing the blocked up nose has caused him to wheeze and cough as well. It is really common in young children and why they won't diagnose asthma at this age Hopefull yonce the cold passes the cough and wheeze will go. Just keep managing the symptoms with the inhaler you have been given
Add message | Report | See allSaltire Sat 19-Feb-11 09:23:20
If you go to the link and then click on UK site, it says 6 months on teh jar of vapour rub. The link initially takes you to the US site
Add message | Report | See allmaxybrown Sat 19-Feb-11 09:45:18
ooh sorry about that I didn't notice blush
I am sure it USED to say 2 years on the pot - I remmeber not getting it for DS at the time and he was not a "baby" but def under 2 so got Boots own in the end
But I agree with bumble too anyway smile
Add message | ReportPumpkinBeans Sat 19-Feb-11 11:34:32
Thanks, he is still wheezy today but not coughing as much. The inhaler definately seems to make a difference for a good few hours.
The crackle sound when he breathes does sound ever so much like when he had a chest infection but I suppose thats all part of wheezing!
Im staying away from the vicks from now on just in case it does have anything to do with this. Kind of like I cant eat croissants now as they were the last thing I ate before I got gastro really bad a few weeks ago!
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Add message | Report | See allSaltire Sat 19-Feb-11 12:09:30
I get a lot of chesty coughs. I also ahve asthma - it's usually very wellc ontrolled and never need to take inhalers.
I find that if I rub vicks in it seems to "break" (for want of a better word) the infection and causes my cough to b elooser. I that makes sense. Then my wheeze increases, but I've always been todl that it's the infection causing the air tubes to narrow.
However, if you're not happy then don't use it. There are children's versions availiable - snufflebabe and karvol, Boots or a chemist will have them.
Asthma | Clinical Features and Diagnosis
Add message | ReportPumpkinBeans Sun 20-Feb-11 15:46:21
Thanks again, he is most definately lots better today. Cutting down the inhaler now. Next time he has a blocked nose I will stick to the baby section!
Making small, simple changes can help limit your asthma symptoms and minimize episode triggers in a big way. Around your house, for example, there are a number of things you can do — from getting rid of dust mites and mold to keeping pets out of your bedroom, according to allergy and asthma specialist Richard J. Lee, MD, of Advanced Specialty Care in Danbury, Conn. Read on for more asthma-soothing tips that can leave you breathing easier.
Have a Cup of Coffee
asthma 2
Start your day with a steamy cup of coffee and you could savor up to four hours of better airway function. That's what a recent analysis of seven small studies, published in the Cochrane Database of Systematic Reviews, part of the Cochrane Library, concluded. What's the secret to asthma relief? The chemical structure of caffeine is a lot like theophylline, an asthma drug used to relax airway muscles. It reduces respiratory muscle fatigue, which can help with wheezing and shortness of breath. One caution about coffee: Avoid caffeine before lung function tests, as it could skew the results.
Get a Magnesium Boost
asthma 3
Not getting enough magnesium may worsen asthma symptoms. According to a study from Bastyr University in Kenmore, Wash., magnesium supplements can work as a natural asthma soother. Study participants included 55 men and women, ages 21 to 55, with mild to moderate asthma. For six and a half months, one group took a 170 milligram magnesium supplement twice a day, while the other group did not. The group who took magnesium reported better breathing, better control of their asthma, and better quality of life overall.
Change Your Toothpaste
asthma 4
It seems strange (and evidence is anecdotal), but certain toothpaste ingredients can trigger asthma for some people. Switching formulas or brands might help. An often cited report from the New England Journal of Medicine describes a young woman who found her asthma reactions were due to the wintergreen flavoring in her paste-based toothpaste. The symptoms went away when she switched to a spicy gel formula.
Stay Awake from Smoke
asthma 5
You probably know you shouldn't smoke or let people light up inside your house, but smoke from a wood stove or fireplace could cause you just as much trouble. Hot, dry air tends to trigger asthma. On top of that, wood stoves emit volatile organic acids that cause even more drying. Pellet stoves, according to Dr. Lee, are slightly better for some people, in part because they're well sealed. Keep in mind that smoke from cooking can also trigger asthma, so run the exhaust fan to clear out kitchen fumes.
Give Dust Mites the Boot
asthma 6
Allergic asthma is often triggered by microscopic dust mites in your home. One of the easiest and fastest steps you can take to keep these tiny insects under control is to cover bedding with mite-proof barriers, zippered covers in which you encase your mattress and pillows. Then wash all your linens at least once a week in hot water — 150 degrees; anything less won't kill the critters. You can't eliminate dust mites altogether, but you can make your bed into a mite-free zone for asthma relief.
Control Your Climate
asthma 7
Keeping the humidity in the air in your home between 30 and 50 percent can help asthma symptoms. Any higher, and dust mites thrive. Mold also grows in high humidity. If your home is damp and humid, clean with fungicides and use a dehumidifier, an air filtration system, or central air conditioning. On the other hand, if the air is too dry, your respiratory tract reacts. You may actually need to add back some humidity into the air during dry, winter months.
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Clear Out Cockroaches and Ladybugs
asthma 8
Cockroaches are one of the worst allergy and asthma triggers, says Lee, and getting an exterminator to eliminate them is worth your while. But another insect trigger you may not know of is the ladybug. "And ladybugs cross-react with cockroaches," Lee adds. Whenever ladybugs arrive in droves, they settle around the house and then break down into a dust-like powder that's a powerful allergen. It might sound mean, especially to seemingly innocent ladybugs, but Lee recommends that you vacuum them.
Get Reacquainted With a Dust Cloth
asthma 9
A review of vacuum cleaners, including ones with HEPA (high-efficiency particulate air) filters, published in the journal Environmental Science & Technology, found that although vacuums can suck up dust bunnies and other allergens that make you sneeze and wheeze, some work better than others. Both the machines and the act of vacuuming itself stir up allergens, worsening your exposure and your reactions. Furthermore, bacteria can live in the vacuum cleaner bag for up to two months. Those same bacteria get reintroduced into the air every time you turn on the machine. To help your asthma, try using a dust cloth with furniture spray or a cloth sweeper that attracts and holds fine particles — it may be more effective and less expensive. If you rely on a vacuum cleaner, even in part, consider upgrading to one with the latest technology, make sure it works correctly, and change the filter and bag regularly.
Is menthol good for asthma?
Flunisolide is used to prevent and control symptoms (wheezing and shortness of breath) caused by asthma. This medication belongs to a class of drugs known as corticosteroids. It works directly in the lungs to make breathing easier by reducing the irritation and swelling of the airways.This medication must be used regularly to prevent breathing problems (attacks of wheezing/shortness of breath). It does not work right away and should not be used to relieve an asthma attack. If an attack occurs, use your quick-relief inhaler as prescribed.
How to use Flunisolide-Menthol Aerosol
Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. Follow the illustrated directions for the proper use of this medication. If you have any questions, consult your doctor, pharmacist, or respiratory therapist.
Shake the canister well before each use. Inhale this medication by mouth, usually 2 times a day or as directed by your doctor. The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on age.
If 2 or more inhalations/puffs for each dose are prescribed, wait at least 1 minute between them. Shake the canister well between each puff.
If you are using other inhalers at the same time, wait at least 1 minute between the use of each medication, and use this drug (the corticosteroid) last.
What is Asthma? Causes, Signs and Symptoms, Diagnosis and Treatment.
To prevent dry mouth, hoarseness, and oral yeast infections from developing, gargle, rinse your mouth with water and spit out after each use. Do not swallow the rinse water.
Use this medication exactly as prescribed. Follow the dosing schedule carefully. If you have any questions, ask your doctor or pharmacist.
Keep track of the number of inhalations used. Discard the canister after using the labeled number of inhalations on the package, even if it feels as though there is medication left in the canister. Follow the instructions for cleaning the mouthpiece. Do not wash the metal canister or put any part of it in water.
Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time(s) each day. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.
Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased.
Learn which of your inhalers you should use every day (controller drugs) and which you should use if your breathing suddenly worsens (quick-relief drugs). Ask your doctor ahead of time what you should do if you have new or worsening cough or shortness of breath, wheezing, increased sputum, worsening peak flow meter readings, waking up at night with trouble breathing, if you use your quick-relief inhaler more often (more than 2 days a week), or if your quick-relief inhaler does not seem to be working well. Learn when you can treat sudden breathing problems by yourself and when you must get medical help right away.
If you are regularly taking a different corticosteroid by mouth (such as prednisone), you should not stop taking it unless directed by your doctor. Some conditions (such as asthma, allergies) may become worse when the drug is suddenly stopped. If you suddenly stop taking the drug, you may also have withdrawal symptoms (such as weakness, weight loss, nausea, muscle pain, headache, tiredness, dizziness). To help prevent withdrawal, your doctor may slowly lower the dose of your old medication after you begin using flunisolide. Tell your doctor or pharmacist right away if you have withdrawal. See also Precautions section.
You may begin to feel this medication working within a week, but it may take 4 weeks before the full benefit of this drug takes effect. Tell your doctor if your condition does not improve or if it worsens.
Dry/sore throat, hoarseness, a bad taste in the mouth, headache, or voice changes may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Rarely, this medication may cause severe sudden worsening of breathing problems/asthma immediately after use. If you have sudden worsening of breathing, use your quick-relief inhaler and seek immediate medical attention.
Because this drug works by weakening the immune system, it may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Tell your doctor right away if you have any signs of infection (such as ear pain, sore throat, fever, chills). Use of this medication for prolonged or repeated periods may result in oral thrush (yeast infection). Contact your doctor if you notice white patches in your mouth or on your tongue.
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Tell your doctor right away if any of these rare but very serious side effects occur: unusual tiredness, vision problems, easy bruising/bleeding, puffy face, unusual hair growth, mental/mood changes (such as depression, mood swings, agitation), muscle weakness/pain, thinning skin, slow wound healing, increased thirst/urination.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Before using flunisolide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as menthol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye disease (such as cataracts, glaucoma), liver disease, thyroid problems, diabetes, stomach/intestinal problems (such as diverticulitis, ulcer), bone loss (osteoporosis), current/past infections (such as tuberculosis, positive tuberculosis test, herpes, fungal), bleeding problems, mental/mood conditions (such as psychosis, anxiety, depression).
If you have switched from a corticosteroid taken by mouth (such as prednisone tablets) to this inhaler within the past 12 months, or if you have been using this product in higher-than-usual doses for a long time, it may be more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used a corticosteroid taken by mouth within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. Carry a warning card or medical ID bracelet that says you use (or have used) corticosteroid medications.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication may mask signs of infection. It can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.
Tell your health care professional that you are using flunisolide before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).
This medication may temporarily slow down a child's growth if used for a long time. However, poorly controlled asthma can also slow down growth. See the doctor regularly so your child's height can be checked.
During pregnancy, this medication should be used only when clearly needed. Infants born to mothers who have been using this medication for an extended time may have low levels of corticosteroid hormone. Tell your doctor right away if you notice symptoms such as nausea/vomiting that doesn't stop, severe diarrhea, or weakness in your newborn. Discuss the risks and benefits with your doctor.
Do you suffer from Asthma? 3 exercise to boost your breathing muscles.
It is not known if flunisolide passes into breast milk and the effect on a nursing infant is unknown.
The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.
To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.
Some products that may interact with this drug include: aldesleukin, other drugs that weaken the immune system (such as azathioprine, cyclosporine, cancer chemotherapy), mifepristone.
This product may interfere with certain lab tests (such as skin tests). Make sure laboratory personnel and all your doctors know you use this drug.
This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
Notes
Do not share this medication with others.
Laboratory and/or medical tests (such as cortisol levels, eye exams, height/weight measurements, bone density tests) may be performed to monitor your progress and check for side effects.
Avoid allergens (such as pollen, pet dander), irritants, smoking/secondhand smoke, and other factors that make asthma worse. Most people with asthma or ongoing lung disease should receive a flu shot annually. Discuss with your doctor.
In adults, this medication can increase the risk of bone loss (osteoporosis) if used for a long time. Talk with your doctor about your risk, and about available treatments for osteoporosis. Lifestyle changes that reduce the risk of bone loss include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. To help prevent osteoporosis later in life, encourage children to exercise and eat a healthy diet (including calcium).
5 Natural Ways to Reduce Asthma Issues | Sadhguru
Learn to use a peak flow meter and use it daily. Promptly tell your doctor if your condition persists or worsens (such as readings in the yellow/red range or increased use of quick-relief inhalers).
Missed Dose
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
Storage
Store at room temperature. Because the canisters are under pressure, do not puncture or burn. Do not use or store near open flame or high heat (more than 120 degrees F/49 degrees C). Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
What triggers asthma attacks at night?
Nocturnal Asthma Facts
A type of asthma that gets worse at night is called nocturnal asthma.
Environmental allergens, stress, hormonal factors, obesity, sinusitis, and more contribute to the worsening of asthma at night.
People with nocturnal asthma develop symptoms such as wheezing, chest tightness, breathing difficulty, and coughing.
Nocturnal asthma symptoms are common regardless of which type of asthma you have – including allergic and non-allergic asthma, exercise-induced asthma, or occupational asthma.
The average sleep quality score for nocturnal asthma patients are lower. For children, it gets as low as 51.
In Orange County alone, 15.9% of asthma cases were reported in 2015-2017.
Image of a Boy with Inhaler and Nocturnal Asthma Text
What is Nocturnal Asthma?
Asthma is a long-term, chronic respiratory disease, caused by the inflammation of the airways. When this condition worsens overnight, we call it nocturnal asthma or nighttime asthma. Regardless of the type of asthma you have, including allergic, non-allergic, occupational, and exercise-induced asthma, nocturnal asthma can occur more than once a month.
Over the past decade, the prevalence of asthma in adults and children has increased in the United States. The California Health Interview Survey states that 15.9% of asthma cases were reported in Orange County in 2015-2017. Although there is no cure for asthma, the symptoms (whether worse during daytime or nighttime) can be managed through long-term medications and short-term quick-relief inhalers. A few home remedies and other tips (we"ll look into those later in this blog) can also help patients with nocturnal asthma sleep better.
What Factors Contribute to Night Time Asthma Attack?
The factors that contribute to nocturnal asthma include:
Environmental allergens
Cold air
Hormonal factors
Stress
GERD (Gastroesophageal Reflux Disease)
The supine sleeping position
Obstructive sleep apnea
Sinusitis
Obesity
Increased mucus production
What Are the Symptoms of Nocturnal Asthma?
The symptoms of nocturnal asthma and regular asthma are the same, but a few may get worse at night, which include:
Shortness of breath
Wheezing
Chest tightness
Coughing
In addition, people and especially children may develop other sleep issues, including:
Common Asthma Triggers
Excessive daytime sleepiness
Sleep-maintenance insomnia
Sleep-disordered breathing like sleep apnea
Parasomnias like sleepwalking
What to Do During an Asthma Attack Without an Inhaler at Night?
Follow these tips to survive a night-time asthma attack without an inhaler:
Sit straight to keep your airways open
Stay calm, as stress or panic can worsen your symptoms
Take long, deep breaths to reduce symptoms
Asthma can be triggered by dust, cigarette smoke, and other allergens. Stay away from triggers and go to any area with clean air.
A cup of coffee can open up your airways and provide you some relief
Seek emergency medical attention if symptoms persist
Tips to Sleep Better with Severe Asthma At Night
Nocturnal asthma is associated with poor sleep quality. This condition of sleeplessness and its effects are worse for children. The average total sleep quality score of children affected by asthma is 51, which is above the clinical cut off of 41, but it indicates the pervasive sleep disturbances among this population.
Here are a few tips that can help you sleep better with asthma at night:
Keep Your Bedroom Clean
Pet dander, dust mites, and other indoor allergens can trigger or worsen asthma symptoms. Clean your bedroom regularly to improve the indoor air quality and keep these factors out.
Related Blog: 4 Ways How Poor Air Quality Can Negatively Affect Your Health
Wash Your Bed Covers and Blankets
Wash your bedding in hot water every week. The water should be at least 130 degrees Fahrenheit so that it can kill dust mites and other allergens in your bedding.
Use Dust-Proof Pillow Covers and Mattress
Zippered pillow covers are tightly woven to keep allergens and dust mites out of your bed covers. Dust and allergens are more common during summertime you keep your windows open that allows the dust to enter your room. Learn more about 14 ways to prevent summertime asthma attacks
Use Humidifier
Cold air can trigger or worsen asthma symptoms at night. During winter, you can use a humidifier to increase your bedroom’s air quality. Dust mites usually develop in low humidity. By increasing humidity, you can keep the dust mites out of your room.
Avoid Sleeping with Pets
Pet dander can trigger asthma symptoms, so don’t sleep with pets. Make sure to close your bedroom door to keep your pet and their dander out.
Consider Your Sleeping Position
If you have acid reflux, cold or sinus infection, lying flat can trigger an asthma attack. You can sleep keeping your head propped slightly up with a pillow to avoid a night-time asthma attack.
Undergo Sleep Apnea Test
People with asthma may experience sleep apnea, which are frequent pauses in breathing during sleep. Sleep apnea can worsen asthma symptoms. Undergo a test to diagnose sleep apnea and take treatments if required.
First Aid For Asthma Attacks (1/3) - Mild attack
Nocturnal Asthma FAQs
Can You Die in Your Sleep From Severe Asthma?
Asthma causes sleep disturbances and usually wakes up people from sleep, so it is unusual to die because of asthma during sleeping, unless heavily sedated for some other reason. However, asthma can be fatal if you are not seeking proper medical attention to treat worsening symptoms.
Does Steam or Vaporizer Reduce Chances of an Asthma Attack at Night?
Generally, steam or vaporizer can liquefy mucus when breathing problems are caused by an allergy or cold. This can help a person feel better. On the other hand, asthma is caused by chronic inflammation of the airways, making it difficult to breathe. Steam or vaporizer can cause irritations and worsen breathing problems.
Does Melatonin Improve Sleep in Asthma?
Researchers have revealed that the hormone melatonin plays a vital role in improving the sleep cycle in asthma patients. Melatonin helps in regulating human circadian rhythms and is believed to have sleep-inducing activity. Additionally, melatonin studies suggest that it affects smooth muscle tone and inflammation too. Both of which helps in improving the sleep cycle for asthma patients at night.
Does Honey Treatment Help in Improving Sleep with Asthma?
Coughing is one of the symptoms of nocturnal asthma, which can be reduced by taking two teaspoons of honey with warm water or cinnamon before you go to bed. Honey can increase saliva production, which can ease your cough by lubricating your airways and reduce inflammation in the bronchial tubes that causes breathing difficulty.
Does a CPAP Help in Asthma Attack at Night?
If there is an issue of carbon dioxide retention during an asthma attack, your doctor is more likely to recommend a BiPAP (Bilevel Positive Airway Pressure), as opposed to a CPAP (Continuous Positive Air Pressure). However, many patients with mild asthma have reported of using a CPAP machine without any problems.
Visit your doctor as soon as you suspect that you have asthma or asthma-like symptoms. Seeking immediate medical attention from an urgent care near you can also help you control an asthma attack and manage the symptoms. Visit our Woodbridge Walk-In Urgent Care in Irvine, Fountain Valley Urgent Care, or Costa Mesa Urgent Care to get seen.
Can Vicks VapoRub cause breathing problems?
New research out of Wake Forest University Baptist Medical Center suggests that Vicks® VapoRub®, the popular menthol compound used to relieve symptoms of cough and congestion, may instead create respiratory distress in infants and small children. Vicks VapoRub may stimulate mucus production and airway inflammation, which can have severe effects on breathing in an infant or toddler.
The study appears in this month's issue of Chest, the peer-reviewed journal of the American College of Chest Physicians, and reports that the product may stimulate mucus production and airway inflammation, which can have severe effects on breathing infants or young children because of the small size of their airways.
"The ingredients in Vicks can be irritants, causing the body to produce more mucus to protect the airway," said Bruce K. Rubin, M.D., lead author of the study and a professor in the department of pediatrics at Brenner Children's Hospital, part of Wake Forest Baptist. "Infants and young children have airways that are much narrower than those of adults, so any increase in mucus or inflammation can narrow them more severely."
Vicks® VapoRub® was first compounded in 1891, in Greensboro. It was introduced in 1905 with the name Vick's Magic Croup Salve. The flu epidemic of 1918 increased sales from $900,000 to $2.9 million in just one year and Procter & Gamble has since marketed the product as "The only thing more powerful than a mother's touch."
First Aid For Asthma Attacks (2/3) - Moderate attack
The salve is widely used to relieve symptoms of colds and congestion, but there are few data supporting an actual clinical benefit, according to Rubin. Vicks has been reported to cause inflammation in the eyes, mental status changes, lung inflammation, liver damage, constriction of airways and allergic reactions.
Interest in conducting the study developed after Rubin and colleagues treated an infant who was taken to the emergency room after developing severe respiratory distress following the application of Vicks directly under her nose. Researchers sought to determine the effect of the product on the respiratory system using ferrets, which have an airway anatomy and cellular composition similar to humans. The team conducted tests on healthy ferrets and ferrets that had tracheal inflammation (simulating a person with a chest infection) that measured the effects of Vicks on mucus secretion and buildup in the airways, and fluid buildup in the lungs.
Results showed that Vicks exposure increased mucus secretion in both normal and inflamed airways. In addition, the studies showed that exposure to the product decreased the rate by which mucus was cleared from the trachea.
The findings support current product labeling, which indicates the product should not be used on children under 2 years of age. However, many parents continue to use Vicks on their sick children, often rubbing the salve on the feet or chest, Rubin said.
"I recommend never putting Vicks in, or under, the nose of anybody—adult or child," Rubin said. "I also would follow the directions and never use it at all on children under age 2."
Even when directions are followed, Vicks will make people with congestion more comfortable, but it does nothing to increase airflow or actually relieve congestion, Rubin added.
"Some of the ingredients in Vicks, notably the menthol, trick the brain into thinking that it is easier to breathe by triggering a cold sensation, which is processed as indicating more airflow," he said. "Vicks may make you feel better but it can't help you breathe better."
In addition to Vicks® VapoRub®, decongestants are not recommended for young children.
"Mucus is one of the most effective ways that our body protects our air passages like the nose and bronchial tubes," Rubin said. "However, lots of mucus and inflammation can cause congestion, especially in little noses. Cough and cold medicines and decongestants are dangerous and neither effective nor safe for young children. Medications to dry up nasal passages also have problems," Rubin said. "The best treatments for congestion are a bit of saline (salt water) and gentle rubber bulb suction, warm drinks or chicken soup, and, often, just letting the passage of time heal the child."
Dr. Rubin also notes that if a child is struggling to breathe, it is a medical emergency and would require the child to be seen by a doctor as quickly as possible.
Co-researchers for the study were Juan Carlos Abanses, M.D., and Shinbu Arima, M.D., both of Wake Forest University Baptist Medical Center.
Why can't asthmatics use Vicks?
The popular remedy that parents rub on their children’s chests to ease symptoms of cough and congestion could have the opposite effect and cause babies and young children to have respiratory distress, said US researchers who tested the product on laboratory ferrets (they have similar airways to humans). They investigated the product after seeing a young child who had developed severe respiratory distress after having some Vicks put on her top lip just under her nose: she was admitted to hospital for emergency treatment.
The research was the work of lead author Dr Bruce K Rubin, a professor in the department of pediatrics at Brenner Children’s Hospital, part of Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina, and colleagues and is published in the January issue of the journal Chest, the peer-reviewed journal of the American College of Chest Physicians.
Rubin and colleagues suggest that Vicks VapoRub may stimulate the production of mucus and inflame the airways, which can severely affect breathing in infants and toddlers because their airways are narrow.
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As Rubin explained:
“The ingredients in Vicks can be irritants, causing the body to produce more mucus to protect the airway.”
“Infants and young children have airways that are much narrower than those of adults, so any increase in mucus or inflammation can narrow them more severely,” he added.
Rubin said that the salve is used by many people seeking relief from cough and cold symptoms, but there is very little clinical evidence to support this. Instead, it has been reported to cause inflammation in the eyes, changes to mental states, inflammation in the lungs, damage to the liver, constriction of the airways and allergic reactions.
The product first came on the market in 1905 bearing the brand “Vick’s Magic Croup Salve”, after which in just one year, sales went from nearly 1 million to nearly 3 million US dollars, this was during the 1918 flu pandemic. Since then the product, which is marketed by Proctor & Gamble, has carried the slogan “The only thing more powerful than a mother’s touch”.
Rubin and colleagues decided to investigate the salve after they treated a baby that was admitted to the emergency room with severe respiratory distress following the application of Vicks directly under her nose. They examined the effect of the product on ferrets because their airway physiology is similar to that of humans (both in anatomy and cellular composition).
The researchers tested the product on healthy ferrets and ferrets with tracheal inflammation, which is like a person with a chest infection. They measured how much mucus was secreted and collected in the airways, and how much fluid gathered in the lungs.
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The results showed that not only did Vicks increase the rate of mucus secretion, in both normal and inflamed airways, it also reduced the rate at which the mucus cleared from the airways.
The findings confirm the product labelling that says clearly it should not be used on children under 2 years old; but many parents use it on their babies and toddlers, rubbing it into their feet and chest, said Rubin.
Rubin told the press that people should never put Vick under their nose, whether adults or children.
“I also would follow the directions and never use it at all on children under age 2,” he said.
Rubin said that Vicks might make you feel better, but it won’t necessarily make you breathe better. Some of the ingredients “trick the brain”, he said, and make you think that you are breathing more easily by triggering a sensation of cold, which the brain perceives as increased airflow.
It’s not just Vicks, but any decongestant is not recommended for young children. Mucus plays an important role in protecting air passages, and sometimes in small airways this can cause congestion.
“Cough and cold medicines and decongestants are dangerous and neither effective nor safe for young children,” said Rubin, adding that “Medications to dry up nasal passages also have problems.”
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“The best treatments for congestion are a bit of saline (salt water) and gentle rubber bulb suction, warm drinks or chicken soup, and, often, just letting the passage of time heal the child,” said Rubin, explaining that if a child struggles to breathe, he or she should be seen by a doctor as quickly as possible.
Vicks Vaporub is a topical medicine designed to relieve cough in cases of the flu and colds. It is considered safe for kids age 2 years and older, provided you follow the package directions carefully. However, Vicks will not relieve an asthma cough in a child with asthma.
New research suggests that Vicks VapoRub, a popular menthol compound used to relieve symptoms of cough and congestion, may instead create respiratory distress in infants and small children.
Many people with asthma find warm air soothing. A steam bath -- in a sauna or your shower at home -- can help clear out mucus that can make it hard to breathe. One word of caution: Some people find that heat makes their asthma worse, so it's important to know your personal triggers.
I didn’t know Vicks was bad for asthma, but the other answers here make sense, good to know.
In the same way similar substances to that used in Vicks, ‘tea tree oil’, eucalyptus and menthol, are used in lip balms, skin lotions and shampoos.
These claim to be ‘healing’ or ‘soothing’ but they are just the opposite. People like the tingling sensation and mistake that for healing. But - that tingling means that your skin, lips or scalp is being IRRITATED. The opposite of healing. This may make some conditions worse, not better.
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