Problem #1 A patient newly diagnosed moderate asthma receives prescriptions for a metered dose inhaler (MDI)...

Problem #1

A patient newly diagnosed moderate asthma receives prescriptions for a metered dose inhaler (MDI) of albuterol and a dry powder inhaler containing the combination of salmeterol and beclomethasone.

· How do the uses of these two prescriptions differ from each other? What are the consequences of overusing each?

Assume the patient was in a hurry one morning, inadvertently grabbed her dry powder inhaler, and left her albuterol MDI at home. Later that day while at a friend’s house, she began feeling tightness around her chest and shortness of breath, which she correctly deduced were the initial phases of an impending asthma attack.

· If the patient confused her two prescriptions and attempted to use her salmeterol/beclomethasone inhaler as rescue therapy, what would you anticipate happening?

Expert Solution

Albuterol is a beta2 agonist also known as salbutamol. It is a short acting drug, that can be used in sudden attack of asthma as a rescue therapy. But the daily and prolonged use of albuterol causes desensitisation of beta2 receptor of lungs and the action of albuterol will be less effective. So it should be used only in an acute attack. Salmeterol is a long acting beta 2 agonist. When it is combined with corticosteroids like beclomethasone, it increases the sensitivity of beta2 agonist to the salmeterol and also prolong the duration of action. Hence salmeterol and beclomethasone combination are used for long term prophylaxis and prevention of asthmatic attack. It will not relieve the acute symptoms of asthma. So the patient will not get benefited in an acute attack of asthma. In acute attack if albuterol is not there, then the patient should go to emergency department and get a nebulisation of salbutamol and an intravenous hydtocortisone if needed.

Nightingale answered 2 years ago

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