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- Title
Regular (up to 10 puffs 4-hourly) inhaled salbutamol should be prescribed at discharge after an asthma attack: myth or maxim?
- Authors
Warraich, Sara; Bush, Andrew; Levy, Mark L.; Fleming, Louise
- Abstract
Over the past 20 years, the concept of asthma weaning plans on discharge after an attack has crept into common practice, although the precise origin of these plans is unclear. High use of short-acting β2-agonists (SABAs) may result in tolerance to their bronchodilator effects, thus diminishing their efficacy, particularly when they are most needed at the time of an acute attack. Furthermore, key warning signs of a deterioration in asthma control may be masked and the weaning plan may encourage the over-use and over-reliance on SABAs. Side-effects from over-use may also occur, including lactic acidosis, downregulation of the β2-adrenoreceptor, increased allergen response and pro-inflammatory effects. The need for asthma education at discharge, a personal asthma action plan and vigilance about prescribing and ensuring adherence to maintenance therapy are definitely important. However, the current authors conclude that the benefit of prescribing regular salbutamol (up to 10 puffs every 4 h) at discharge after an acute asthma attack is a myth, and a very dangerous one.
- Subjects
DRUG therapy for asthma; ASTHMA prevention; BIOMARKERS; ADRENERGIC beta agonists; DRUG efficacy; ADRENERGIC receptors; ALBUTEROL; INFLAMMATION; DRUG overdose; EVIDENCE-based medicine; LACTIC acidosis; BRONCHODILATOR agents; MYTHOLOGY; DRUG therapy; DRUGS; INHALATION administration; DRUG side effects; PATIENT compliance; DISCHARGE planning; PATIENT discharge instructions; DISEASE complications
- Publication
Breathe, 2023, Vol 19, Issue 3, p1
- ISSN
1810-6838
- Publication type
Article
- DOI
10.1183/20734735.0054-2023