How much albuterol is safe? - Asthma Message Board

DreamsandWishes · 02-16-2007, 07:45 PM

I am seventeen years old and have had asthma for most of my life. I am currently taking a flovent inhaler and zyrtec as well as an albuterol inhaler. I am very athletic and find myself wheezing and reaching for my albuterol more and more during athletic competitions (I always take two puffs 20 minutes before a game with a spacer). There have been some games where I have taken 5-6 puffs of my albuterol within an hour. I am just wondering if there are any serious side effects of using it this much.
Also, I am wondering if there are any fast-acting alternatives to albuterol because whenever I take it not involving exercise, I shake for the first 2-3 hours. I find myself wheezing and not taking it during a regular day at school because I hate shaking for so long. Last, could my not using it during the day when I am wheezing contribute to my trouble breathing during sports?

I am sorry this is so long but I can't seem to find the answers to my questions. Thank you!

Titchou · 02-16-2007, 10:18 PM

Don't use the spacer with the albuterol. Just hold the inhaler out from your mouth a little bit. You aren't getting enough with the spacer. And my doctor told me I could use it every two hours. I'm a jogger and was running a race that was very late starting. I ended up have an attack because the albuterol wore off before the middle of the race due to the late start. Your doctor may tell you something different but these were my instructions.

DreamsandWishes · 02-18-2007, 08:09 PM

thank you Titchou but I think that my doctor told me that the spacer helps the medicine get into my lungs instead of in my mouth. If I were to try your advice, how far from my mouth do I hold the inhaler? Thank you!

Titchou · 02-18-2007, 08:16 PM

I hold it about 1 inch away. That was how I was instructed to use it. Seems different docs do different things but it works for me. I did use the spacer with my Flovent until they changed the formula (doing away with the CFAs) and now just hold it out as well.

Laenini · 02-19-2007, 07:06 PM

I would suggest you mention to your doctor how much you are having to use your inhaler during physical activity. To me it means your asthma is not as controlled as it could be, and a change in your maintenance medications may make a big difference for you. Generally, we say that if you are needing a rescue dose of an immediate acting inhaler more than twice a week your asthma needs fine tuning. Using 5-6 doses in 1 hour definitely exceeds that benchmark.

In a medically supervised setting (like a hospital ICU) large doses of albuterol are given through a nebulizer very frequently, even continuously in rare instances to try to break a life threatening asthma attack. Its a pretty safe drug from that point of view. But over use of a rescue inhaler is very dangerous in another way. It means that there is underlying inflammation in your airways. Swollen airways only need to spasm a tiny bit to set off wheezing and shortness of breath. Airways without swelling can handle more reactiveness or spasms before causing noticeable symptoms. Using a rescue inhaler 5 times in 1 hour can mask that underlying inflammation without treating it thereby putting you at the risk of a very serious asthma attack. So see your doctor, your Flovent may need to be increased, or maybe an inhaler like Advair may prove to be a better choice for you. Either way its worth a trip to the doctor.

With practice, many adults can get just as good of results from their inhaler by holding it an inch or so out from the mouth before firing off a dose as they can by using an aerochamber or spacer device. And many people find it handier to not have to carry around a spacer. Children (and some elderly persons) are better off with the spacer though, particularly if they are unable to coordinate their breath intake with the actuation of the inhaler.