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Can Albuterol Cause Rebound Asthma?

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Posted on Sat, 17 Sep 2016
Question: Asthma questions: I. Can albuterol or other asthma inhalers commonly cause rebound asthma, similar to anxiety medications causing rebound anxiety? II. How long of a period of time normally goes by before uncontrolled moderate persistent asthma or uncontrolled severe asthma results in airway remodeling? (With all due respect, doctors other than Dr. XXXXXXX Rynne please.)
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Answered by Dr. Prof. Kunal Saha (1 hour later)
Brief Answer:
Possible

Detailed Answer:
Thanks for asking on HealthcareMagic.

Albuterol can induce hypersensitivity of the respiratory airways and cause rebound asthma.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC171402/

However, I have not observed this to be a cause for concern.

About the question relating to airway remodeling, I would need more information about the ongoing pathology in order to be able to give a definitive answer.

Feel free to write back.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prof. Kunal Saha (12 hours later)
Thank you Dr. Saha.

Details on pathology are these: I moved into a toxic mold environment three months ago, and have been getting steadily worsening breathing problems ever since. These breathing problems manifest as asthma which is experienced throughout each day and at night, sometimes lasting several hours at a time. I have mast cell activation disorder, so I am experimenting with different medications to try and control this asthma, which is as of yet not controlled. X-rays do not reveal any abnormalities, and I am scheduled to get lung functioning testing done this week to assess possibility of hypersensitivity pneumonitis from the mold, to be confirmed by CT scan. I am trying to relocate soon as possible right now, but wondering what my potential risk for airway remodeling is from the as yet uncontrolled asthma.
doctor
Answered by Dr. Prof. Kunal Saha (4 hours later)
Brief Answer:
Nebulization would provide better relief. Home kits available.

Detailed Answer:
Thanks for clarifying.

I would insist you to go for nebulization with 0.9% NaCl solution (normal saline) unless have wheezing. It will hydrate the lungs and would improve the situation. Take Albuterol (nebulization) as and when required for wheezing.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Prof. Kunal Saha (46 minutes later)
I have some saline and a nebulizer. Pulmonologist I saw last week said he did hear some wheezing at base of lungs. Is there a contraindication between nebulizing agents with NaCl if there is wheezing? Sometimes I get nebulizer medications compounded in sterile NaCl.
doctor
Answered by Dr. Prof. Kunal Saha (19 minutes later)
Brief Answer:
They are mutually advantageous

Detailed Answer:
Thanks again for writing back. There is no contraindication between the two. Rather, one augments the other. Feel free to take saline nebulization.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Prof. Kunal Saha (15 hours later)
My pleasure and thank you for your answer Dr. Saha. I'm experimenting with different compounded albuterol medications since I have mast cell activation disorder. Since I may also have hypersensitivity pneumonitis from the mold exposure, is there a way to assess what percentage of albuterol inhalers develop hypersensitivity of respiratory airways from albuterol use?
doctor
Answered by Dr. Prof. Kunal Saha (12 hours later)
Brief Answer:
Infrequent.

Detailed Answer:
Thanks for writing back.

I searched the medical literature but could not come up with any definite figure about the frequency of hypersensitivity developed in response to albuterol. It does not seem to be common however.

Although not directly related, perhaps you would like to go through:
http://erj.ersjournals.com/content/25/5/864

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

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Can Albuterol Cause Rebound Asthma?

Brief Answer: Possible Detailed Answer: Thanks for asking on HealthcareMagic. Albuterol can induce hypersensitivity of the respiratory airways and cause rebound asthma. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC171402/ However, I have not observed this to be a cause for concern. About the question relating to airway remodeling, I would need more information about the ongoing pathology in order to be able to give a definitive answer. Feel free to write back. Regards