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Dear Class,</p>
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I have had a few of you asking the same question about asthma medications and Michelle and I wanted to clear a few things up. There have been questions about using albuterol as a rescue inhaler.</p>
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Here are the details.</p>
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Albuterol has always been the rescue inhaler of choice. Its action of opening up the airway acts very quickly and ends quickly (ideal for a rescue medication).</p>
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Many of the maintenance medications are combos (ICS + LABA)</p>
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Patients don’t like having 2 different inhalers (rescue and maintenance)</p>
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The new guidelines you were hearing about from pharm (SMART therapy) is a push to use the combo medication as the rescue inhaler. This would eliminate the need for 2 inhalers.</p>
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Here is the catch…..Not just any combo inhaler (ICS + LABA) can be used!</p>
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<i><u>What you need to know is the beta-agonist medication.</u></i></p>
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<b>Albuterol</b><span> </span>acts quickly and ends quickly.</p>
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<b>Salmeterol</b><span> </span>takes a long time to act but lasts a long time once it starts working, making it a great LABA to be used in combination with an inhaled steroid (Advair is the standard here).</p>
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<b>Formoterol<span> </span></b>has the best of both worlds. Recent studies showed that formoterol does have the ability to both act quick and lasts a long time. This is why the guidelines say you can use this formulation as both a rescue medication and as a
maintenance medication.</p>
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Please take note<span> </span><b>Symbicort</b><span style="margin:0px;font-size:10.5pt;line-height:14.98px;font-family:Roboto;color:rgb(77, 81, 86)"><span> </span>(budesonide and formoterol)</span><span> </span>is the only combo that is approved for SMART therapy
and this is only in the guidelines for ages 5 and up for moderate or severe persistent asthma (this is not in guidelines for mild asthma).</p>
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<b>Advair<span> </span></b>(<span style="margin:0px;font-size:10.5pt;line-height:14.98px;font-family:Roboto;color:rgb(77, 81, 86)">fluticasone / salmeterol</span>) is not used as a recuse inhaler!</p>
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This is why albuterol is still the main standard for rescue medication and is used routinely for asthma exacerbations/attacks. In emergency care settings (urgent care, primary care office for sick visit, ER), we use albuterol!</p>
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I hope this helped a little. As always feel free to contact me with any questions. Good luck studying and best of luck on Monday!</p>
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Drs. Kesic & Hernandez</p>
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