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Types Of Rescue Inhalers For Asthma

What Are The Most Common Side Effects Of Albuterol And Levalbuterol Inhalers

What are the Different Types of Asthma Inhalers?

People who use these inhalers typically have no side effect issues, but a few potential ones are worth mentioning. Keep in mind that this is not an all-inclusive list of side effects that can happen with these medications.

  • Throat irritation. Because these medications are inhaled, they may cause throat irritation as they pass into the lungs. A drink of water after the inhalation will help relieve the irritation.

  • Rapid heart rate. For some people, these medications can cause palpitations or increase their heart rate. This may be more noticeable with albuterol, or if you use either medication more than every 4 to 6 hours.

  • Headache and dizziness. Both medications can cause blood vessels to narrow, possibly leading to headache or dizziness.

  • Hyperactivity or tremor. Because the medications can cause blood vessels to constrict, they may make you feel more hyperactive or cause shaky hands. Again, this generally occurs when too much of the medication is taken.

Researchers dont know for sure whether levalbuterol or albuterol causes more side effects. Clinicians are still debating this topic, and research is inconclusive. However, levalbuterol is thought to be less bothersome because it acts mainly on the lungs, while albuterol is more likely to affect other parts of the body.

How To Use A Metered Dose Inhaler

Metered dose inhalers have pressurized canisters inside that release a fine mist into your lungs. The pressurization helps to propel the medication into your lungs.

  • Prime the inhaler first. You need to do this when you use an inhaler for the first time or if you havent used it for 2 weeks or more. To prime, shake your inhaler for 5 seconds, turn it away from you and press down to spray it.
  • Wait a few seconds and do it again. Repeat two additional times.
  • Put the mouthpiece between your teeth and close your lips tightly around it. Make sure your tongue doesnt block the opening. You can also hold the mouthpiece about the width of two fingers away from your mouth.
  • Press the top down and breathe in until your lungs fill completely, about 4 to 6 seconds.
  • Hold the medicine in your lungs as long as you can, then breathe out.
  • If you dont get enough air in the first breath, wait 15 to 30 seconds and try again. Shake the canister again before the next puff.
  • Recap the mouthpiece.
  • If your medicine has a steroid in it, rinse your mouth and gargle with water after you use it and then spit out the water.

Can Medicine Alone Help My Asthma

Not usually. Although medicines help a lot, they may not be able to do the job alone. You have to avoid the things that cause or trigger your asthma symptoms as much as you can. Asthma triggers can be found outside or inside your home, school, or workplace.

Improving the indoor air quality in your home is an important part of asthma control. Your indoor air can be more polluted than outside air. Our interactive Healthy Home can show you ways to improve the indoor air quality of your home. A healthier home can reduce your exposure to allergens and irritants.

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Common Rescue And Maintenance Asthma Meds

Within these two types of asthma management inhalers, there are multiple types of medications that each work a little bit differently. Although learning about all the different types of asthma medications can be overwhelming, its good news because that means more options to find the right medication balance.

Rescue inhaler medications:

  • Combinations of multiple medication types

What Are The Types Of Bronchodilators

Asthma Rescue Inhalers Over The Counter

There are three main types of bronchodilators: beta 2-agonists, anticholinergics and theophylline.

Beta 2-agonists

Beta 2-agonists exist in short-acting forms and long-acting forms.

Short-acting beta 2-agonists quickly open your airways to stop asthma symptoms. People sometimes refer to SABAs as reliever or rescue medicines because theyre the best medications for treating sudden, severe or new asthma symptoms.

SABAs work within 15 to 20 minutes and last for four to six hours. You may also use them 15 to 20 minutes before exercising to prevent asthma symptoms that arise from physical activity.

In inhaled forms, SABA medications include:

You may take long-acting beta-2 agonists twice a day for long-term control and maintenance of your airways. You should also use LABAs with an inhaled corticosteroid to treat asthma. Corticosteroids help reduce swelling in your airways and lungs. LABAs are also effective in treating exercise-induced asthma.

LABAs are available as a dry powder inhaler . These medications include:


Anticholinergics are available as ipratropium bromide and tiotropium bromide . They block the effects of acetylcholine. Acetylcholine is a neurotransmitter that your body makes.


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What Are Bronchodilators

Bronchodilators are medications that relax muscle bands that tighten around your airways. This opens the airway and lets more air move in and out of your lungs. That helps you breathe more easily. Bronchodilators also help remove mucus from your lungs. Open airways mean mucus can move more freely, too, and you can cough it up.

Almost all people with asthma use a bronchodilator to help open their airways.

Short-acting bronchodilators are used as a “quick relief” or “rescue inhalers”, while long-acting bronchodilators can be used every day to control asthma — along with an inhaled steroid.

When To Contact A Doctor

People with asthma should have regular appointments with a healthcare team to monitor the condition and ensure that their medication is still suitable.

The American Lung Association states that a person should contact a doctor straight away if they experience any of the following:

  • flaring the nostrils when breathing
  • rapid breathing
  • the skin between the throat and ribs appearing stretched while inhaling
  • finding it difficult to walk or talk
  • inhalers not relieving symptoms

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Asthma Inhaler Type: Dry Powder Inhaler

Dry powder inhalers are used for control medications such as long-acting beta-agonists and inhaled corticosteroids .2 These inhalers cannot be used with a valved holding chamber or spacer. To use these inhalers, you must be able to breathe in forcefully enough to draw the medication into the lungs.

Figure 4. Dry powder inhalers

Instructions for dry powder inhalers vary by device, so reading the instructions for your inhaler is especially important. Some product websites also have videos with a demonstration. General guidelines for using a dry powdered inhaler are:2,3

  • Do not shake your inhaler.
  • Load a dose according to the instructions for your device. You may need twist the inhaler or slide the cover. Each device is different.
  • Turn away from the inhaler and exhale.
  • Put your mouth around the mouthpiece.
  • Breathe in rapidly and deeply for 1 to 2 seconds.
  • Hold your breath for 10 seconds.
  • Rinse out your mouth with water and spit it out, especially if you are taking an inhaled corticosteroid. Rinsing helps to prevent thrush . It also reduces the amount of medication you swallow.
  • Asthma Rescue Inhalers Are Crucial In Asthma Control

    Inhalers (Asthma Treatment & COPD Treatment) Explained!

    Nov 30, 2020 | rescue

    * The albuterol in rescue inhalers opens breathing tubes quickly

    * If it doesnt quickly improve your breathing, go to the ER

    * A spacer should be used with all liquid medicine inhalers

    * Generic albuterol is now available for about $22 per inhaler

    You and I both know this your rescue inhaler is your go-to when the wheezing starts.

    Why? Because you get immediate relief .


    This type of inhaler creates a cloud of medicine: either

  • dry medicine particles or
  • medicine droplets
  • that are carried deep into your lungs with a deep breath.

    When this medicine hits the inner lining of your breathing tubes , it soaks into the muscle layer around the tubes, causing them to relax. That makes the tube get larger inside, allowing more air to move. This makes your breathing much easier.

    The medicine in these inhalers is albuterol or a variant of it. It has a short duration of action which means:

    • it works quickly but
    • It wears off quickly.

    For this reason, it is meant for temporary relief.

    In a typical asthma action plan, albuterol is used for immediate relief or what we call RESCUE.

    If it works, you are encouraged to consult with your doctor to understand what triggered that wheeze.

    If we cant be sure that youll be able to avoid that trigger, additional medication will be prescribed to overcome this sensitivity.

    There are some issues:


    It is reasonable to try a second dose according to your Asthma Action Plan, but


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    What Are The Forms Of Bronchodilators

    There are two forms of bronchodilators:

    • Short-acting bronchodilators. Short-acting bronchodilators quickly relieve or stop sudden asthma symptoms. Theyre effective for three to six hours. Another name for a short-acting bronchodilator is a rescue inhaler. Inhalers are canisters of medicine in a plastic holder with a mouthpiece. When you spray an inhaler, it gives a consistent dose of medication.
    • Long-acting bronchodilators. Long-acting bronchodilators keep your airways open for 12 hours. You use these inhalers every day to prevent asthma attacks.

    When Are Albuterol And Levalbuterol Inhalers Used For Asthma And Copd

    Both albuterol and levalbuterol inhalers are prescribed to people over the age of 4 with bronchospasms caused by asthma or COPD. Albuterol inhalers are specifically also approved for exercise-induced bronchospasms, or difficulty breathing during intense physical exercise. Taking albuterol 15 to 30 minutes before you exercise can help prevent breathing issues.

    Both drugs are meant to be used as needed for severe asthma- or COPD-related breathing problems. They are not intended for everyday use as long-term maintenance treatment. If you find yourself needing albuterol or levalbuterol more often than prescribed, talk to your provider to find a better option for managing your symptoms.

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    Will Medicine Help Me Breathe Better When I Exercise

    Yes. Exercising, particularly in cold air, may cause airway swelling or exercise-induced bronchoconstriction . Quick-relief asthma medicines, taken before exercise, usually control this. If you need repeated doses of quick-relief medicine during and after exercise talk with your doctor. Your medicines may need to be adjusted. Thanks to these medicines, many Olympic and professional athletes have successful sports careers even with their asthma.

    It is important for everyone, including people with asthma, to be as active as possible for good health. Talk with your doctor about how you can be physically active while keeping your asthma well-controlled.

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    Do Asthma Medicines Have Side Effects

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    Yes. All medicines have side effects. Tell your doctor how you are responding to the treatment and if you have any side effects. Follow up often with your doctor so you can control your asthma with the least amount of medicines and with the fewest side effects.

    Medical Review: June 2021 by S. Allan Bock, MD Maureen George, PhD, RN, AEC, FAAN and Sumita Khatri, MD, MS

    References1. Bonds, R., Asawa, A. and Ghazi, A. . Misuse of medical devices: a persistent problem in self-management of asthma and allergic disease. Annals of Allergy, Asthma & Immunology, 114, pp.74-76.e2.

    Asthma Action Plan

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    Why A Child Might Need An Inhaler

    Inhalers are a mainstay of asthma treatment because they either help stop an attack or prevent one from happening. To manage childhood asthma, healthcare providers may prescribe one of three types of inhalers for kids:

    Things To Know About Albuterol

    In serious cases, taking albuterol could cause your airways to tighten suddenly. This is called a bronchospasm and can make breathing difficult. This side effect happens immediately after using the inhaler. It can occur the first time you use a new canister. If this happens to you,call your doctor, and use a different asthma treatment.1-3

    People withheart problemsshould be cautious about taking albuterol. Albuterol can cause changes in blood pressure, heart rate, and other heart disease symptoms. These effects are rare with the recommended dose of albuterol. Albuterol may also worsen conditions like thyroid problems, seizures, diabetes, or low potassium levels.1-3

    Overusing your albuterol inhaler can worsen your asthma. Studies show that taking albuterol regularly can lead to worselung functionandasthma control. Albuterol is meant to provide occasional quick relief of symptoms, not long-term control. Using albuterol more than 2 days per week is a sign of poor asthma control. If you find yourself using albuterol often, consider discussing your asthma control options with your doctor.6

    Before starting albuterol, tell your doctor about any prescription medicines, vitamins, supplements, or over-the-counter drugs you are taking. Certain medicines affect the way albuterol works, including other asthma drugs, other inhaled medicines,beta-blockers, diuretics, digoxin, monoamine oxidase inhibitors , and tricyclic antidepressants .1-3

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    What Are The Side Effects Of Bronchodilators

    The side effects of bronchodilators vary according to which type you use.

    Side effects of beta 2-agonists include:

    • Nervous or shaky feelings.
    • Trouble sleeping.

    Some beta 2-agonists, including albuterol, are available as pills or syrups. You may have more side effects when you take these forms because theyre a higher dosage. You also absorb them through your bloodstream.

    Side effects of anticholinergic drugs include:

    • Dry throat, eyes and nose.
    • Nausea and vomiting.
    • Temporary blurred vision if the medicine gets in your eyes.

    Anticholinergic drugs may make it difficult to urinate . Talk to your healthcare provider if you have any conditions that affect your bladder. These conditions may include benign prostate enlargement , bladder stones or prostate cancer.

    Side effects of theophylline include:

    • Nausea and vomiting.

    Each Persons Asthma Is Different

    How to correctly use an asthma inhaler

    The NAEPP EPR 3 guidelines suggest moving patients up and down a set of stairs. Its called the stepwise approach. The doctor decides whether to move you up and down the stairs depending on your symptoms.1

    Your doctor may ask if your asthma wakes you up during the night and if so how often. He may also ask how often you are using your rescue inhaler , or if your asthma interferes with your daily activities.1 You can see how you are doing by taking the Asthma Control Test.2

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    Asthma Inhaler Type: Metered

    Metered-dose inhalers are used for rescue medications and control medications such as long-acting beta-agonists and inhaled corticosteroids .2Figure 1. Metered dose inhaler

    General guidelines for using a metered-dose inhaler are:2,3

  • Shake the inhaler.
  • Breathe out until your lungs are empty.
  • Place your mouth around the mouthpiece.
  • Start inhaling, press on the canister to release one puff while continuing to breathe in for 3 to 5 seconds.
  • Hold your breath for 10 seconds afterward.
  • Rinse out your mouth with water and spit it out, especially if you are taking an inhaled corticosteroid. Rinsing helps to prevent thrush . It also reduces the amount of medication you swallow.
  • If you are taking more than one puff of a rescue medication, wait 15 to 30 seconds before taking the next puff. For other medications, there is no need to wait between puffs
  • Metered-dose inhalers can be difficult to use. It is hard to coordinate releasing the medication and breathing in. This is particularly hard for young children and elderly adults. If you use a valved holding chamber, you do not need to coordinate the puffing and breathing.2

    What Are The Two Main Types Of Bronchodilator Medicines

    There are beta 2-agonists and anticholinergics.

    Short-acting beta 2-agonists

    In inhaled forms, these medications include:

    • Albuterol and ipratropium bromide combination .

    Short-acting beta 2-agonists are called reliever or rescue medicines because they stop asthma symptoms very quickly by opening the airways. These are the best medications for treating sudden and severe or new asthma symptoms. They work within 15 to 20 minutes and last four to six hours. They are also the medicines to use 15 to 20 minutes before exercise to prevent exercise-induced asthma symptoms. If you need to use your short-acting beta 2-agonists more than twice per week, talk to your doctor. This is a sign of unstable asthma and your doctor may want to change the dose of the long-term control medicines you take.

    Long-acting beta-2 agonists

    • Combination medications: salmeterol and fluticasone formoterol and budesonide formoterol and mometasone vilanterol and fluticasone salmeterol and fluticasone and salmeterol and fluticasone . These contain both the long-acting beta agonist and an inhaled corticosteroid.

    Side effects of beta 2-agonists include:

    • Nervous or shaky feeling.
    • Trouble sleeping .

    Anticholinergic drugs

    Side effects of anticholinergic drugs are minor. The most common side effect is dry throat. If the medicine gets in your eyes, it might cause blurred vision for a short period of time.

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    When A Nebulizer Is Used Instead

    Babies and very young children with asthma who aren’t yet able to manage an inhaler typically receive inhaled medications via a nebulizera machine that turns the medicine into a mist.

    With a nebulizer, liquid medication for asthma is placed into a cup. On one side, the cup is connected to a mask that will fit over a young childs mouth and nose. On the other side, it’s attached to tubing. The tubing runs into a motorized device. When you turn on the motor, the liquid medication is vaporized and comes out into the mask.

    Babies, toddlers, and young children dont have to do anything to receive the correct dosage of medication. They just need to breathe in the midst. It can take some time to get your child comfortable using the mask. Arranging a simple activity that encourages them to sit still, like looking at a picture book, will help ensure they get the required dosage.


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