nl1097

I am new here, have had asthma for years. Been using the inhaler for about
15 years. Now have a nebulizer with albuterol as well.
I have read a few posts on here that say Albuterol (ventolin) is bad.
Nobody has elaberated on this statement.
Does anyone have any links to information about why they make the claim it
is bad?
Thanks
NN

joy

NN

The regular medical community admits basically to two problems with
albuterol use.

Continuous beta-agonist use by asthma patients results in decreased
bronchodilator response to subsequent beta-agonist administration and
causes asthma patients to develop a tolerance for the drugs, making
beta-agonists less effective in true emergencies. And there is some concern
about cardiovascular effects. I know my daughter who has POTS cannot use
albuterol for instance without severe reactions (tremendous increases in
heart rate). However, very few people have this problem and you would know
if you did, believe me.

Two other "concerns" discussed recently, but not espoused by the medical
community relate to Richard's contention that albuterol causes the
inspiratory muscles to become weakened and that these weakened muscles are
in turn responsible fo wheezing in asthmatics. You may go back and read
through these recent discussions for yourself.


http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=3b227dfa.0407201021.2f6e5c6a%40posting.google.com&rnum=7&prev=/groups%3Fq%3Dasthma%2Brichard%2Bwheezing%26hl%3Den%26lr%3D%26ie%3DUTF-8%26scoring%3Dd%26selm%3D3b227dfa.0407201021.2f6e5c6a%2540posting.google.com%26rnum%3D7

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=4JLPc.199956%24a24.136829%40attbi_s03&rnum=2&prev=/groups%3Fq%3Dasthma%2Brichard%2Bwheeze%2Bjoy%26hl%3Den%26lr%3D%26ie%3DUTF-8%26scoring%3Dd%26selm%3D4JLPc.199956%2524a24.136829%2540attbi_s03%26rnum%3D2

The other group that comes to mind is Buteyko. They contend that
hyperventilation is the cause of asthma, and the albuterol causes you to
hyperventilate, worsening your asthma. You can also read about that for
yourself. The reason you didn't get an answer right away is that this has
been discussed to death. So if these links don't answer your question, go to
google groups and do a search.

2004 so far.

January

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=b4a5e89e.0312310131.5c5c4a9%40posting.google.com&rnum=19&prev=/groups%3Fq%3Dkolb%26start%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma.*%26scoring%3Dd%26selm%3Db4a5e89e.0312310131.5c5c4a9%2540posting.google.com%26rnum%3D19

February

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=l9BUb.226196%24I06.2474988%40attbi_s01&rnum=17&prev=/groups%3Fq%3Dkolb%26start%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma.*%26scoring%3Dd%26selm%3Dl9BUb.226196%2524I06.2474988%2540attbi_s01%26rnum%3D17

March

Couldn't find any, but made up for it in April

April

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=Nv7lc.1682%24a47.1073%40newsread3.news.atl.earthlink.net&rnum=13&prev=/groups%3Fq%3Dkolb%26start%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma.*%26scoring%3Dd%26selm%3DNv7lc.1682%2524a47.1073%2540newsread3.news.atl.earthlink.net%26rnum%3D13

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=40807346.1311016%40news.wn.com.au&rnum=16&prev=/groups%3Fq%3Db%2Bbreathing%26start%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma.*%26scoring%3Dd%26selm%3D40807346.1311016%2540news.wn.com.au%26rnum%3D16

May

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=3b227dfa.0405071158.5f446b24%40posting.google.com&rnum=11&prev=/groups%3Fq%3Dkolb%26start%3D10%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma.*%26scoring%3Dd%26selm%3D3b227dfa.0405071158.5f446b24%2540posting.google.com%26rnum%3D11

June

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=o06mc0lju0sliho22akippe8cqeeti3nps%404ax.com&prev=/groups%3Fnum%3D25%26hl%3Den%26lr%3D%26ie%3
DUTF-8%26group%3Dalt.support.asthma%26start%3D175


July

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=3b227dfa.0408050811.2163fe32%40posting.google.com&prev=/groups%3Fnum%3D25%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma%26start%3D75


August

http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&threadm=ABlYc.35844%24N11.27129%40bignews5.bellsouth.net&prev=/groups%3Fnum%3D25%26hl%3Den%26lr%3D%26ie%3DUTF-8%26group%3Dalt.support.asthma%26start%3D25

Joy

nn

Thanks for your response, like I said I'm new here. I don't go back and
research every topic prior to asking a question.

What I really meant was does anyone know of links to scientific reports
supporting these claims. I'm sure everyone has their own opinion, but I
prefer medical research to Usenet opinions.

I was in the ER a couple of days ago, and was very weak and ill when I saw a
couple of posts.
This is the first I have been on for several days, so have no idea how long
it may have taken to get a response.

Thanks so much for all your effort.
I appreciate your going to the trouble for me.

joy

NN,


I am sorry you have been down. Certainly everyone in here has been through
at least one of those periods.

People posting generally only quote the studies which support them, so what
you read here isn't always very balanced. You can go to Pubmed and see what
your own literature searches reveal, but I have never seen anyone collate
that information (someone likely has - the drug manufacturer!, we just
aren't privy to it). Just remember, when it comes to doing literature
searches, things are almost never cut and dried. Each side can quote studies
that support their postition.

I believe in these links, with the back and forth discussions (politely
stated) the regular medical establishment's point of view and the altmed
point of view (well, two groups anyway) are represented. If you read
through the threads I provided, you will see why each side sees holes in the
other side's contentions. And they do sometimes post studies to support
their claims. Some of the studies are a bit dated, so watch out for that.

If you ever get around to a detailed literature search, let us know what you
find.

Joy

00doc

I think just making the blanket statement that "albuterol is
bad for you" is obviously wrong. In low doses of one or two
puffs every once in a while I think yuo would be hard
pressed to find any serious adverse effects supported by
scientific literature other than that of a small minority of
people that will experience an increase in heart rate and
possibly feel jittery. That is not to say that it does not
have some issues.

What I think people point to mostly is the stuff Joy
mentions regarding regular use of high doses of it. At one
time it was common for docs to prescribe "standing doses"
given 4 times per day (just take it that often regardless of
symptoms). The practice became markedly less common after it
was noted that people with albuterol prescribed this was
died more often. It was never determined if this observation
was due to the need for frequent dosing refecting poor
control of asthma (i.e. they died of the disease and not the
drug) or if it was from abnormal heart rhythms triggered by
the albuterol (i.e died of the drug - which is theoretically
possibly). I think most experts assume there was some
component of both but would be hard pressed to say how much
of each.

A more recent study looked at kids with asthma and the drug
salmeterol which is a long acting version of albuterol. In
this study it was found that adding salmeterol without a
steroid produced adverse events while adding it with a
steroid was helpful. This study was able to show that at
least most of this effect was due to poor control of the
asthma.

Another issue, also mentioned by Joy, is that with regular
doses of albuterol the effectiveness of the drug decreases
(called "tachyphylaxis"). This happens because if the
receptors are stimulated too much the cells literally remove
some of them from the cell surface. Taking steroids (inhaled
or oral) causes the cells to put more receptors on the cell
surface and so can help combat this.

In addition to stimulating the heart high, doses of
albuterol can also cause electrolyte abormalities (mostly
low potassium) but the doses needed to do this would be hard
to achieve by inhalation (similar drugs are given IV for
several different reasons).

Lastly, athlete's abuse of a similar drug, clenbuterol, has
lead to some speculation. This drug has been shown to reduce
the breakdown of muscle tissue and so is being abused as an
anabolic agent. Some people speculate that the increase
diagnosis of asthma in elite athletes stems from attempts to
hide illegal use of this drug. Personally, I'm sure it is
happening but the pattern of athletes getting the diagnosis
(more swimmers and long distance runners than strength
athletes) suggests that at least some of the increased
diagnosis is from real disease (although they may be looking
for the dual effect on their respiration). As always, when
elite athletes die people presume that ilicit performance
enhancing drugs may have something to do with it (as do I)
and many of these athletes have been taking clenbuterol -
but rarely that alone. Again, you would have a difficult
time achieving the doses we are talking about here with an
inhaler.

Basically, if your asthma is well controlled and you are
using rescure doses infrequently (not several times a day)
the medication is unlikely to be dangerous other than some
side effects of jitteriness and fast heart rates. If you are
requiring it often then you need to have a talk with your
docs about the poor control of your asthma.

--
00doc

alison chaiken

"Joy" <none@nospam.com> writes:

In the scientific literature, an ****ysis and collation of previously
published studies is often termed a "meta-****ysis." Searching PubMed
for "albuterol meta-****ysis" should help you find higher level papers
instead of primary clinical studies. Using this search strategy, I
found for example this:

http://bmj.bmjjournals.com/cgi/content/full/323/7319/976

--
Alison Chaiken "From:" address above is valid.
(650) 236-2231 [daytime] http://www.wsrcc.com/alison/
Q.: Why did the Governor allow Indian tribes to build a casino in San Pablo?
A.: Because the prison guard's union wasn't interested.

joy

Thanks. Did you see anything that would refute what has already been said?


"Alison Chaiken" <alison+gnus20040912T102844@dailyplanet.dontspam.w srcc.com>

ellis

It is now recognized that asthma is an inflammatory process,
and long term treatment should be with anti-inflammatory
drugs, like steroid inhalers. Short acting bronchodilators
like albuterol should be reserved for rescue, not maintenance.
Failure to treat with antiinflammatory drugs can lead to
'remodeling' of the lung. Link:

http://www.vh.org/adult/provider/familymedicine/FPHandbook/Chapter04/05-4.html
University of Iowa Family Practice Handbook, Fourth Edition, Chapter 4

Pulmonary Medicine: Asthma
Excerpts:
"I. Definition.
Asthma is an inflammatory disease of the airways characterized by
reversible airway obstruction.
.........
IV. Management
General Principles of Management. Anti-inflammatory medications
should be considered the mainstay of asthma therapy. Medications
used for maintenance and rescue therapy are different.

V. Chronic Medications
A. Antiinflammatory drugs are the mainstay of asthma therapy.
1. Inhaled corticosteroids. Indicated for all severities of
asthma with the exception of mild intermittent asthma.
........
C. Short-acting beta2-agonists. Scheduled use of short-acting
bronchodilators is generally not recommended. Control with
scheduled use of beta-agonists is not as good as that achieved
with PRN use. Short-acting beta2-agonists (e.g., albuterol,
terbutaline, pirbuterol) should be used PRN for wheezing and
symptom exacerbation, before exercise, etc"
--------------------
More details in the report [pdf]:
Practical Guide for the Diagnosis and Management of Asthma
http://www.nhlbi.nih.gov/health/ prof/lung/asthma/practgde/practgde.pdf
------------------------------