March 28, 2023

Using Albuterol rescue Inhaler in Asthma treatment is most common, but overuse of it can lead you to worst trouble!

Good morning my name is dr chet tharp and i’m a board certified allergy and asthma specialist in south carolina so for this video blog i want to discuss albuterol use in asthma i think this is probably one of the most misunderstood medications in all of medicine but definitely the most misunderstood medication in the world of asthma you know on an almost

Daily basis i encounter patients in various settings including urgent care settings or more commonly now through telemedicine who are looking for refills of albuterol for their asthma you know they often state they use albuterol daily or multiple times per day because they need it for their asthma symptoms such as chest tightness shortness of breath wheeze

Or cough you know they tell me that it’s been prescribed two puffs every four to six hours as needed by previous doctors so they just use it as often as they need per the prescription instructions many tell me they’ve used albuterol several times weekly or daily for several years for these breathing symptoms and that’s just normal for them and then i catch

Them by surprise and i may be catching you by surprise now as well by telling you that albuterol should not be used more than two times in one week excluding prior to exertion again i repeat you should not be using albuterol more than two times in one week unless you use it before exercise or exertion only if you’re using it purely for exercise-induced asthma

Or bronchospasm and need to use a couple puffs prior to exertion for symptom prevention that doesn’t count however if you use it during exertion after initially using it beforehand for prevention or you’re using albuterol at any other time during the week more often than two times your asthma is not controlled and this is not something you know that i’ve just

Made up based on my own personal experiences or opinions as a physician you know this is agreed upon by worldwide asthma guidelines now to clarify you can use albuterol every four to six hours as needed for asthma symptoms it is there for you to use if needed however what many medical providers fail to tell you is that if you’re using it on a regular basis

Again more often than two times in one week excluding prior to exertion your asthma is not controlled and you need to discuss this with them as soon as possible so i’m going to explain in detail why it’s so important to decrease your use of albuterol and get your asthma under you know better control but let’s start by going into what albuterol does because

I think that can be helpful for you and i know that’s how has been helpful for many of my patients albuterol works on receptors in your lung to relax the lung muscle help pop those airways open almost immediately to quote unquote rescue you which is why it’s called a rescue medicine in the first place so when you’re having asthma symptoms and your airways are

Constricted they’re tight albuterol actually works fast to help open them up almost immediately helping you breathe better however you know the effects of albuterol will only last a few hours and then they’re gone so it’s a very temporary measure which is why you can use it as needed every four to six hours because its effects will completely wear off in about

Let’s say four hours it’s very important to recognize that it is only helping relax the lung muscle temporarily and it’s not treating the underlying cause of your asthma which is inflammation think of your asthma as a bleeding wound an albuterol as a band-aid stopping the bleeding temporarily you know the band-aid will cover up the issue for a few hours but the

Wound is still bleeding so the band-aid will need to be replaced in a short time the band-aid isn’t addressing the underlying problem which is the cause of the bleeding it’s just masking it temporarily so now let’s talk about why it’s important to get that uncontrolled inflammation or bleeding so to speak under control and decrease your use of albuterol first

It signifies that you’re at a higher risk of having an asthma attack that will likely require more harmful medications to control it such as oral steroids more importantly though it also means you’re at a higher risk of a bad outcome from asthma such as a hospitalization or even death secondly repetitive use of albuterol may cause it to not work as effectively

Over time so in other words your body or you know the receptors in your lung may become resistant to albuterol over time in the medical world resistance to a medicine is known as this big word called tachyphylaxis and developing tachyphylaxis to albedo is a possibility also as a rescue medicine you want it to work or rescue you when you absolutely need it to

If it doesn’t again you may be at a higher risk of a bad outcome from asthma also since the underlying issue of uncontrolled inflammation is not being addressed chronic inflammation of the lungs can cause lung remodeling and this long remodeling as a result of chronic uncontrolled inflammation is really just a nice way of saying the lungs have become scarred

And scars are permanent and they will permanently decrease the function of your lungs as you know asthma is what we call a reversible lung condition copd or chronic obstructive pulmonary disease which is what we often see in smokers is an irreversible lung condition believe it or not they are basically the same condition with albuterol with i’m sorry asthma

Being reversible and copd being irreversible well we know over time due to remodeling of the lung from uncontrolled inflammation asthma can lose its reversibility and make the transition to copd we call this transition to copd the asthma copd overlap syndrome or acos acos as a result these patients have more difficulty breathing and controlling their lung

Symptoms and have poor outcomes you know another thing to point out is that if you’re using albuterol regularly your lungs are just not optimized they’re not exchanging air as they should be thus you’re probably not performing or exerting yourself you know well at all without having breathing symptoms and you may feel limited in what you can do with respect

To exercise or exertion as a result you may not exercise much you may become inactive and obese which can have a direct impact on your asthma and cardiovascular health in general you know regarding albuterol in my clinic when i prescribe it i don’t give refills unless i’m treating someone who i’m confident only uses it prior to exercise otherwise if i don’t

Give you refills i feel like i’m helping you and myself keep tabs on how much albuterol you’re using and that’s how well controlled your asthma is this is purely to look out for your best interest to not only address a current problem that you’re having by using albuterol too much but also to prevent any issues like lung remodeling or other bad outcomes in the

Future thus as you can see uncontrolled asthma signified by how often you use albuterol can harm you greatly in many ways it is absolutely imperative if you use albuterol frequently such as more than two times in one week excluding prior to exertion your asthma needs to be better controlled thankfully there are many medical options or what we call controller

Medicines that your physician can discuss with you to get your asthma under better control which will ultimately decrease your need for albuterol so as always i hope this has helped you helped you give get a better understanding of albuterol’s use in asthma and i hope it’ll stimulate a productive discussion with your physician about your asthma if you find

Yourself using albuterol more often than you know you should be if you like this video please leave me a comment and subscribe to my email list where i can keep you updated on new videos and educational opportunities through thanks for your support and great days are ahead bye

Transcribed from video
Use of Albuterol in Asthma – are you using it TOO OFTEN? Biggest Mistake! By Chet Tharpe