From the Guidelines
The recommended treatment for patients requiring a rescue inhaler for asthma or COPD is a short-acting beta-agonist (SABA) such as albuterol (also known as salbutamol), which should be used as needed for symptom relief. The typical dose is 1-2 puffs (90-180 mcg) every 4-6 hours as needed for symptoms. For acute exacerbations, up to 4-8 puffs may be used, but frequent or increasing use (more than twice weekly for asthma) indicates poor disease control and should prompt evaluation for additional controller medications. Patients should be instructed to prime new inhalers (4 test sprays into the air), use proper inhaler technique (exhale fully, form a tight seal around the mouthpiece, inhale slowly and deeply while activating the inhaler, hold breath for 10 seconds), and wait 1-2 minutes between puffs if multiple doses are needed. A spacer device is recommended, especially for those with coordination difficulties. SABAs work by relaxing bronchial smooth muscle, quickly opening constricted airways within minutes, with effects lasting 4-6 hours. For patients requiring frequent rescue medication, adding controller medications like inhaled corticosteroids for asthma or long-acting bronchodilators for COPD is essential to address underlying inflammation and prevent exacerbations, as recommended by the American College of Chest Physicians and Canadian Thoracic Society guideline 1. It's also important to consider the patient's individual needs and preferences, as well as the potential risks and benefits of different treatment options, as outlined in the guideline recommendations 1. In addition, patients with COPD may benefit from combination therapy with inhaled corticosteroids and long-acting bronchodilators, as suggested by the guideline recommendations 1. Overall, the goal of treatment is to improve symptoms, reduce the risk of exacerbations, and improve quality of life, while minimizing the risks and side effects of treatment.
From the FDA Drug Label
The use of albuterol sulfate inhalation solution can be continued as medically indicated to control recurring bouts of bronchospasm During this time most patients gain optimum benefit from regular use of the inhalation solution. If a previously effective dosage regimen fails to provide the usual relief, medical advice should be sought immediately, as this is often a sign of seriously worsening asthma that would require reassessment of therapy.
The recommended treatment for patients requiring a rescue inhaler for asthma or chronic obstructive pulmonary disease (COPD) is to use the inhaler as medically indicated to control recurring bouts of bronchospasm.
- Key points:
- Continue use of the inhalation solution as directed.
- If a previously effective dosage regimen fails to provide relief, seek medical advice immediately.
- This may be a sign of worsening asthma that requires reassessment of therapy 2. No information is provided for COPD treatment in the given drug labels.
From the Research
Recommended Treatment for Asthma or COPD
The recommended treatment for patients requiring a rescue inhaler for asthma or chronic obstructive pulmonary disease (COPD) includes:
- Inhaled short-acting β2-agonists (SABAs) such as albuterol for quick relief of symptoms 3
- Inhaled corticosteroids (ICS) in combination with SABAs for patients with uncontrolled moderate-to-severe asthma 4, 5
- A fixed-dose combination of albuterol and budesonide as a rescue medication for patients with uncontrolled moderate-to-severe asthma 4
Benefits of Combination Therapy
The use of a combination inhaler containing a SABA and an ICS as a rescue medication has been shown to:
- Reduce the risk of severe asthma exacerbations 4
- Provide more effective control of asthma symptoms 6
- Have a rapid synergistic potentiation of the anti-inflammatory effect of corticosteroids and the bronchodilatory action of β2-agonists 5
Treatment Options for COPD
For patients with COPD, treatment options include: