Bronchodilators

ALLERGY CONSULTANTS
Ray S. Davis, M.D.
456 N. New Ballas Road, Suite 129
Jeffrey M. Wright, M.D.
St. Louis, Missouri 63141
Susan S. Berdy, M.D.
(314)569-1881
Lisa V. Suffian, M.D.
FAX: (314)569-3277
BRONCHODILATORS
These inhaled medications are prescribed to provide rapid relief of acute asthma symptoms and should NOT BE
USED EVERYDAY on a regular basis. The key features of these inhalers are:
1. Albuterol, Maxair and Xopenex are the most commonly prescribed rescue medicines or quick acting bronchial
openers. They are available by inhaler or nebulizer. They begin to work within minutes and last four-six hours. Albuterol may be sold by other names such as Proair, Ventolin and Proventil but contain the same ingredients. 2. It is preferable for most patients with asthma to rely on preventative “controller” medications to be taken on a daily basis and reserve a short acting rescue medicine, like albuterol, for treating symptoms when they occur, before exercise or exposure to a known allergen. The most common preventative medicines include: Advair, Flovent, Pulmicort, Asmanex, Symbicort or Singulair. 3. Preventative use of a bronchodilator is acceptable in two situations: before vigorous exercise or before exposure to a known allergic trigger. For example, if you are allergic to cats, you will want to use your short acting bronchodilator before you visit a home that has a cat. 4. The inhaler or nebulizer forms of albuterol work quicker than the older oral forms and have fewer side effects. 5. The most common side effects seen with albuterol relate to the fact that it is derived from epinephrine (adrenaline). Albuterol can cause patients to feel shaky, nauseated, nervous or have a rapid heart rate. Some children's behavior may seem more active after a dose of albuterol. Xopenex, when used by nebulizer or inhaler, may have fewer side effects. 6. The inhaler or nebulizer should not be used more than 4 times a day without contacting your doctor. Ideally, you should need fewer than 2 doses of albuterol per week during the day and less than twice per month in the middle of the night, disturbing sleep. If you need to use albuterol daily, it suggests that your asthma is not well controlled and you should notify your doctor. There may be swelling or inflammation of the bronchial tubes or an infection. Your doctor may increase or change your preventative medicine (s), add an oral steroid or prescribe an antibiotic if a bacterial infection is present. 7. Overuse or abuse of albuterol, meaning the use of more than one canister per month, increases the risk of dying from asthma. This typically occurs in patients who fail to comply with daily use of their preventative medications and prefer the "quick fix" of a rescue medicine. 8. Daily use of albuterol over weeks to months can lead to "tolerance" which means that it becomes less
effective and doesn't last as long. When needed in an emergency situation, your inhaler won’t give you the relief that you expect. We will ask you at each visit how frequently you need to use your rescue medicine and whether it is needed to control symptoms or prevent symptoms. Good asthma control will allow you to pursue the activities that you enjoy and to sleep all night without your asthma interfering with your quality of life. 5/2007 Diplomates - The American Board of Allergy and Immunology (A Conjoint Board of the American Board of Internal Medicine and the American Board of Pediatrics)

Source: http://www.stlallergy.com/pdfs/Bronchodilator.pdf