Key TakeawaysRescue inhaler overuse is a problem for many people with asthma.Using three or more rescue inhaler canisters in a year can make asthma symptoms worse, according to a recent study.People with asthma can talk to their providers about taking medication to help control their symptoms to avoid over-relying on rescue inhalers.
Key Takeaways
Rescue inhaler overuse is a problem for many people with asthma.Using three or more rescue inhaler canisters in a year can make asthma symptoms worse, according to a recent study.People with asthma can talk to their providers about taking medication to help control their symptoms to avoid over-relying on rescue inhalers.
If you haveasthma, there might be times when you need to use a rescue inhaler or puffer, also calledshort-acting beta-agonists(SABAs). They’re prescribed to be used at the first sign of asthma symptoms, like trouble breathing, shortness of breath, or wheezing.
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Randy Brown, MD, MPH, a global leader of digital health, immunology, and respiratory medical affairs at Teva and the senior author of the study, told Verywell that overusing rescue relievers is associated with an increased risk ofasthma flare-ups, asthma attacks, and deaths.
Brown and his colleagues studied 359 patients for three months and found that 29% of them used the equivalent of three or more rescue inhaler canisters in a year.
“Among those who exceeded the threshold, the rate ofasthma exacerbationswas substantially higher,” said Brown.
According to Brown, Teva’s digital inhalers allow patients to monitor their inhaler use and may help minimize any adverse outcomes.
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What Happens When You Overuse Your Inhaler
People with asthma may have a rescue inhaler on hand for quick relief but the inhalers should not replace longer-term medications (calledcontroller medications) to treat asthma.
A 2019 study from researchers in Australia found that people who overuse SABAs were more likely to have moderate to severe nasal symptoms. The study also found that 59% of SABA overusers had uncontrolled asthma compared to people with asthma who didn’t overuse the inhalers.
A 2016 study from the University of Arizona found that the overuse of albuterol—a common inhaler medication—was associated with more frequent asthma symptoms, worse asthma control, and even depression.
Joe K. Gerald, MD, PhD, an associate professor of public health policy and management at the University of Arizona and the lead author of the 2016 study, told Verywell that people may think that using their inhalers often would help their asthma.
“When patients use albuterol quite frequently, it can change the way their airways respond to other stimuli,” Gerald said. “When they’re exposed to irritants like cigarette smoke or allergens like pollen, the airways can be ‘twitchier.’ Overuse creates conditions in which the airways become what we call hyperresponsive to stimuli.”
Reliance on inhalers also does not address the underlying problem of uncontrolled or poorly controlled asthma. According to the American Academy of Allergy Asthma and Immunology, if patients rely on rescue inhalers more than twice a week, they shouldsee an allergistand discuss treatment.
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Why People Use Their Inhalers Too Much
According to Gerald, inhaler overuse is fairly common among patients with asthma, and there are many factors that contribute to overuse.
One reason people overuse their inhalers is that they aren’t able to access health care. A person who hasn’t been able toget the right controller medicationmay lean more heavily on an inhaler because it’s often easier to get a prescription for it.
“Over-users also tend to havelower knowledge about asthmaas a disease,” said Gerald. “And they report being less able to manage asthma on their own.”
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As Gerald’s research found, inhaler overuse might also be tied todepression. While the link between albuterol overuse and mental health is not totally clear,depressive symptomsmay change a person’s perception of their asthma symptoms and how well their disease is controlled.
“There have also been some reports that depression has been linked to less responsiveness to the albuterol medication itself,” said Gerald. “The logic is that there are some common physiologic pathways between depression and asthma that might change a patient’s response.”
There is a lot more research to be done, he added.
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Helping Patients Avoid Overusing Inhalers
Brown said that Teva’s technology can allow patients to track and share their usage with their providers.
Once patients are aware of their overuse patterns, their provider can help develop a long-term strategy that addresses the underlying factors contributing to their overuse. For example, people who have uncontrolled asthma may need to be on medications or reduce exposures that cause theirasthma to flare up.
“You want to develop an individualized management plan that allows for better disease control and less risk,” Brown said. “The goal isn’t to take away the rescue medicines altogether.”
He compared a rescue inhaler to any device that helps people in an emergency. It’s an important medication to have when you truly need it, but the goal is to make sure it’s not frequently needed.
“It’s always a good idea to have a spare tire in your car or a fire extinguisher in your house,” said Brown. “But we shouldn’t need to rely on those rescue strategies on a regular basis.”
What This Means For YouOverusing a fast-acting asthma inhaler can have negative health outcomes including worsening asthma control, depression, and even death. It is important that patients with asthma know when to use rescue inhalers and talk to their providers about how to treat uncontrolled asthma.
What This Means For You
Overusing a fast-acting asthma inhaler can have negative health outcomes including worsening asthma control, depression, and even death. It is important that patients with asthma know when to use rescue inhalers and talk to their providers about how to treat uncontrolled asthma.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Teva.Teva announces new findings highlighting potential of ProAir Digihaler (albuterol sulfate) inhalation powder to address asthma treatment challenges.Azzi EA, Kritikos V, Peters MJ, et al.Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists: an Australian community pharmacy-based survey.BMJ Open.2019;9(8):e028995. doi:10.1136/bmjopen-2019-028995Gerald JK, Carr TF, Wei CY, Holbrook JT, Gerald LB.Albuterol overuse: a marker of psychological distress?J Allergy Clin Immunol Pract. 2015;3(6):957-962. doi:10.1016/j.jaip.2015.06.021American Academy of Allergy Asthma and Immunology.Asthma overview.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Teva.Teva announces new findings highlighting potential of ProAir Digihaler (albuterol sulfate) inhalation powder to address asthma treatment challenges.Azzi EA, Kritikos V, Peters MJ, et al.Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists: an Australian community pharmacy-based survey.BMJ Open.2019;9(8):e028995. doi:10.1136/bmjopen-2019-028995Gerald JK, Carr TF, Wei CY, Holbrook JT, Gerald LB.Albuterol overuse: a marker of psychological distress?J Allergy Clin Immunol Pract. 2015;3(6):957-962. doi:10.1016/j.jaip.2015.06.021American Academy of Allergy Asthma and Immunology.Asthma overview.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Teva.Teva announces new findings highlighting potential of ProAir Digihaler (albuterol sulfate) inhalation powder to address asthma treatment challenges.Azzi EA, Kritikos V, Peters MJ, et al.Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists: an Australian community pharmacy-based survey.BMJ Open.2019;9(8):e028995. doi:10.1136/bmjopen-2019-028995Gerald JK, Carr TF, Wei CY, Holbrook JT, Gerald LB.Albuterol overuse: a marker of psychological distress?J Allergy Clin Immunol Pract. 2015;3(6):957-962. doi:10.1016/j.jaip.2015.06.021American Academy of Allergy Asthma and Immunology.Asthma overview.
Teva.Teva announces new findings highlighting potential of ProAir Digihaler (albuterol sulfate) inhalation powder to address asthma treatment challenges.
Azzi EA, Kritikos V, Peters MJ, et al.Understanding reliever overuse in patients purchasing over-the-counter short-acting beta2 agonists: an Australian community pharmacy-based survey.BMJ Open.2019;9(8):e028995. doi:10.1136/bmjopen-2019-028995
Gerald JK, Carr TF, Wei CY, Holbrook JT, Gerald LB.Albuterol overuse: a marker of psychological distress?J Allergy Clin Immunol Pract. 2015;3(6):957-962. doi:10.1016/j.jaip.2015.06.021
American Academy of Allergy Asthma and Immunology.Asthma overview.
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