What Are Rescue Inhalers - Ask The Pharmacist

Sep 2, 2014
The specialist pharmacists in the Express Scripts Pulmonary Therapeutic Resource Center® help those with asthma – and parents of children with asthma – understand and manage the condition effectively.
Tags
  • Asthma
  • COPD
  • Children

While rescue inhalers can be critical in managing a sudden attack, overuse also raises the risk of side effects and adverse events. As the school year begins and children return to class, it is important to understand the proper use and precautions in the use of rescue inhalers.

The specialist pharmacists in the Express Scripts Pulmonary Therapeutic Resource Center® (TRC) help those with asthma – and parents of children with asthma – understand and manage the condition effectively.

Inhaler Basics

Rescue inhalers, such as albuterol and levalbuterol, are commonly prescribed for patients who have lung conditions, including asthma and COPD (chronic obstructive pulmonary disease).  These medications are used to give immediate relief from shortness of breath, wheezing and coughing. 

To the Rescue

For patients who are having shortness of breath or trouble breathing, rescue inhalers can be life savers. Short-acting beta agonists (SABAs), such as albuterol and levalbuterol, are the most common type of rescue inhalers. SABAs travel into the airways when inhaled and activate beta receptors on the smooth muscles of the lungs. This activation causes the muscles to stop constricting and relax, so that the airways can open up and air can travel more freely in and out. SABAs work almost immediately after inhalation, which is important if a patient is having difficulty breathing.

Control Versus Rescue

In order to properly treat the underlying pulmonary conditions, it’s important to understand the role of controller inhalers and how they differ from rescue inhalers. Asthma causes inflammation of the airways and managing it is at the heart of effective treatment.

Inhaled corticosteroids are typically used for control, as they work to reduce inflammation and provide ongoing disease management. They should be used routinely, often once or twice daily, even when the patient is symptom free.

Sometimes the corticosteroid is combined with a long-acting beta agonist (LABA). It is important to note that LABAs work much slower and over a longer period of time than SABAs, so the two should not be confused with one another. Inhaled corticosteroids and LABAs should not be used in rescue situations because they do their work over time and do not work quickly like SABAs.

Rescue Inhalers for Instant Relief

Rescue therapy is primarily about symptom management. But all too often, they are overused. Doing so can cause a patient to develop tolerance to the medication over time and it may not be as effective. Our Pulmonary TRC pharmacists review prescriptions with high usage and higher than normal quantities prescribed for rescue inhalers. When appropriate, they will reach out to the prescriber and to the patient to ensure the medications are only used “as needed.”

Overuse of rescue inhalers may mask the severity of the underlying disease when used multiple times a day. It also can increase the risk of side effects including tachycardia (increased heart rate), insomnia and nervousness.

Here are some quick tips to keep in mind:

  • Rescue medications such as SABAs are intended to be used for immediate symptom relief.
  • Controller medications such as inhaled corticosteroid and LABAs are intended to be used routinely and should never be used in a rescue situation.
  • Avoiding overuse of rescue medications will reduce the likelihood of side effects and improve health outcomes.
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