Patient/caregiver was educated on side effects of using Advair as follows:

1. Hypertension: Steroid in Advair can result in retention of sodium and water and cause elevated blood pressure.
2. Elevated blood sugars: On long-term use, steroid in Advair can result in increased insulin resistance and contribute towards elevated blood sugars. This particularly can be an issue in diabetics with poor blood sugar control.
3. Opportunistic fungal infection: Advair can result in opportunistic fungal infection in the oral cavity, such as, candida with the individual presenting with white patches on the tongue and in the oral cavity. This is secondary to immunosuppression due to the steroid content of Advair.
4. Osteoporosis: Chronic use of steroids can result in osteoporosis with weakening of the skeletal framework and pathological fractures.
5. Secondary bacterial and viral infections: Due to the immunosuppression caused by the steroid in Advair, individuals using Advair are more prone to secondary bacterial and viral infections of respiratory tract. Patients can present with signs and symptoms of infection, such as, fever, throat irritation, productive cough, and stomach upset.
6. Hypokalemia: Chronic use of Advair can result in hypokalemia giving rise to symptoms such as, irregular heartbeat, palpitations, dizziness, tingling, and muscle cramps.
7. Constitutional symptoms, such as, nervousness, trouble sleeping, and irritability can occur secondary to chronic steroid use. Patients can also present with constitutional symptoms, such as, headache, dizziness, cough, throat irritation, nasal congestion, and muscle pain secondary to the long-acting bronchodilator in Advair.