I know I shouldn't have done this....

Last night, I was looking up some info about Albuterol (I have asthma) and came across some info that really frightened me.  On the Arizona Cert website (it lists all drugs that are known to prolong QT interval), it listed symptoms of brief Torsades episodes.  Apparently, if it only lasts a few seconds, it causes symptoms very similar to PVC's (feeling a pause, feeling your breath "catch", lightheadedness, etc.)  This terrifies me.  How can you tell the difference since it is impossible to be monitored all the time?  Sometimes my palps feel very different.  I may have a slight "twitch" or flutter and other times it's a huge pause feeling, followed by breathlessness and dizziness.

I don't see my EP until the 30th and I am so worried.  My husband said he is banning me from looking up stuff on the Internet until then!

[ireneo]

I also have asthma and use albuterol and occasionally beclomethasone (a steroid). Did the info you read say the changes were temporary due to the med or were they permanent from long term use of the med? You and I both know when you use albuterol it causes the HR to speed up since it is an adrenergic med. But it only lasts 10 mins. or so. I've never heard of it causing long term rhythm changes but I don't check into things that much. I've used my asthma meds for years and I feel the same. Perhaps the best person to ask would be the pharmacist or your doctor. I prefer asking pharmacists such questions since they are the chemists, the doctors know which med to choose but even they have to look up interactions and such.

[KLB32]

I think any changes are short lived.  As a matter of fact, I had an EKG back in January about an hour or so after taking Albuterol and it was normal.  QT interval was the lowest it has been on the three EKG's I have had this year.

It's just when I saw that it is listed as a QT prolonging drug and the symptoms of a very brief episode of Torsades is not much different than what I feel sometimes with my palps, I got really nervous.

But what can you do when you have asthma?  You need to breathe and if you let it get out of control and need to go to the ER, that's when you get the really strong meds that can upset heart rythmn.

[fearfactor]

I know, yesterday I took my 7 month old to her doctor and they said she has bronchitis and prescribed albuterol.  I am very loath to give it to her - it also terrifies me when my 5 year old with asthma has to take it.  I'm not saying this to scare you, only to let you know you aren't alone in being drug-wary.  Also, I WAS banned from looking up heart stuff on the internet by a therapist AND my husband.  I don't follow their advice but I should.  I feel better when I do!  So actually, I shouldn't even be here!  ;)

[ireneo]

KLB - we do have that bad habit of breathing, don't we? :-)  And going to the ER for treatment is no fun. One time my lungs were so tight I did the nebulizer twice in ER. Still tight. Someone came in and said, 'Guess we'll have to give you a shot." I said, 'No thanks, my heart is wacky enough on its own. I don't think it needs more drugs." He looked at me funny and left. Guess he didn't read my chart about all my arrhythmias. My lungs finally opened up about an hour later. But please be careful trying to diagnose an arrythmnia based on "sensation." We all feel things differently, even the same problem, PVC's for example, can feel different from day to day. A brief run of torsades de pointes may be difficult to distinguish from v-tach, v-flutter or a burst of PVC's. Only an EKG would tell the true story.

fearfactor - it's a good thing to be informed. But there is that fine line between being informed and being afraid. Not everything we read is true or applies to us. That's where doctors come in. We can learn which questions to ask but finally need to rely on the doctors to sort it all out. Take care.

[pbanders]

Unless you've got an extremely good reason to be rooting around on the internet for drug effects and interactions, then don't. Your husband is right, you'll drive yourself nuts.

[stevie_wonder]

Hi,
I have responded to other messages of yours about Long QT. Our family has it. My 19 year old son had a cardiac arrest from it but was lucky and survived with the help of paramedics. Within an hour before his arrest he took between 6 and 8 puffs of his ventolin (albuterol) inhaler for his asthma. He was also running at the time. He has taken this since he was very small and many times had an increased HR for a short time after. I think because he took too much and not knowing at the time that he had Long QT Syndrome, caused him to have Torsades. He has had one Torsades since but did not have a cardiac arrest. He was also running after taking Ventolin. So I think if you need this for your asthma, still take it until a doctor tells you otherwise, but keep note of your heart rate and don't do anything to increase it more until the HR is back to normal. Like I have stated before, this is really something you should look into. Don't let other people make you feel like you are just looking for something on the internet, LQTS is not as rare as once thought, and it is very treatable once diagnosed. My husband is still in denial, he thinks the doctors are wrong about me and the kids and someday they will find something else.

[ireneo]

I'm an adult and I prefer to use an aero-chamber. It does help to get the meds to the lungs and less at the back of the throat. For young people (and some of us old folks) it reduces the need to be coordinated - puff and inhale within that mini-second. I've never, ever taken more than 2 puffs within a 3-4 hour period. Talk about a buzz! No way. As for reducing the side effects, never heard that one. If the meds are being inhaled properly then you're going to feel something. As for steroids - the rule is to thoroughly rinse/gargle after using to avoid thrush.

[KLB32]

Yes, I do recall you telling me about your son's incident although I didn't realize he had taken Albuterol.  I have never had the need to take that much Albuterol before.  Usually my max is two puffs and I typically just do one to see if I will even need a second puff.  Fortunately, I just needed one last night and it didn't cause an fast HR or skipped beats.

Did your son ever mention what the Torsades episode felt like (the one he had when he did not go in cardiac arrest)?  Like I said before, it has been reported to feel like what is typical with palpitations so it's hard to know if you're in trouble or not.

Since your family has confirmed LQTS, what have his doctors told him to do regarding asthma control? It seems like most fast acting inhalers can cause heart rythmn problems.

My husband is well-intentioned but he's one of those people who thinks everything happens to other people and not our family.  I am trying to remain calm until my appt. with the EP on the 30th but it's so hard. :(

[KLB32]

Update:  I just called the EP's office to see if there was a chance there were any cancellations for Monday so I could move my appt. up.  There was a cancellation so now they can move my appt. up from the 30th to the 23rd!  I feel so much better now that I won't have to wait an extra week!

[dmil241]

I hope that this isn't a stupid question but my daughter has asthma also and takes many daily meds for maintenance. She takes albuterol a few times a week because she is very active and her pulminologist told us to have her use it before those activities. Do you use a chamber with your albuterol inhaler? Our pulminologist requires it and said that it helps to cut down on side effects such as an increase HR. ???? Does anyone else know anything about this? Do you think it is true or not? I wonder if it would help?

[KLB32]

I have used a chamber before but that was with a steroid inhaler.  I was told it would help get the medicine in my lungs and less in my mouth where it could cause possibly cause thrush (yuck).

Is she young?  Sometimes young children have a hard time using the inhaler properly and the chamber just helps get the medicine in the lungs.  I have never heard that it cuts down on the side effects.

If she needs her inhaler more than a few times a week, you should ask her Dr. about getting her on a preventative drug like pulmicort or flovent.  They work really well.

[dmil241]

She is 11 now and has had problems since she was about 18months. She takes allegra, singulair, flonase, flovent and foradil everyday as a preventative. Then the pulminologist told us to give her albuterol before sports practices and games. About once a year, she seems to have an attack where she has to take multiple neb treatments or go to the ER. She is very active in sports.

[Barbarella]

My husband had to get off Albuterol because it caused him to have chest pains which is one of the side effects listed and his Pulmonary Specialist also said it can cause chest pain in some people.

[stevie_wonder]

When he had his cardiac arrest he said that everything just went black. He doesn't remember anything until he woke up at the hospital almost an hour later. The second time he collapsed he said that it felt like he couldn't breath and he tried to cough to clear his lungs but he just went black and collapsed. He came to about 2 minutes later. The Torsades must have stopped on its own. It usually does. But that was before he was on Betas, he has only had near fainting since. And he did say that it feels like a flutter in his chest and severe shortness of breath. That is also what my 9 year old experiences when he gets dizzy while exercising. He hasn't had anymore since being on Betas. Because his asthma is severe he has to take his ventolin when he needs it. He just has to restrict his activities when his asthma acts up. He takes daily Flovent and it helps prevent the asthma pretty well. He is on Atenolol and it is not too bad for the asthma not like some of the other Beta blockers. I am happy to hear that you only have to wait a couple more days. Make sure you write everything down that you want to ask at the appt. Good luck!