Ventilan Addiction ?

[umgambit]

Hi.
I am thirty years old and have been an asthmatic since childhood. I have been doing fine after several treatments during puberty, although I always carry a Ventilan pump and use it eventually.
I have noticed that I can pass long periods of time without inhalating Ventilan, but sometimes I use it when feeling a very slight (perhaps psychological) broncho-constriction. When this happens I feel I need Ventilan more and more and tree-four days after the first episode I am using it a lot. Then I must make a mental effort not to use it and one, two days after I'm OK.
This suggests to me that an addiction phenomena may be involved, and would like to have your opinion.

Thank you for your time,
F.

[National Jewish]

Asthma varies from person to person.  For some people the symptoms will come and go.  For others the symptoms are constant.  Asthma symptoms are caused by the following changes in the lungs

[AndyRRT]

Hi Kate,

Thats a very good question, and an important one at that.

First lets discuss how Albertol effects our body. This drug is a a beta agonist. Or a beta "stimulant. The sympathatic nervous system has two inervative sites. They are called Beta 1 and Beta 2 receptors. Albuter ol effects both of these sites. Stimulating the Beta 2 sites causes bronchodialation. The major effect we desire when using this medication. Stimulating the Beta 1 receceptors stimulates the side effects which can be an increased heart rate, tremors and that nervousness feeling.

Now, regarding your heart condition (which I don't know), your doctors have prescribed you a Beta Blocker. Some common medications used are: Atenolol, Metoprolol, and Propranolol.  These drugs are commonly used to help prevent cardiac conditions like high blood pressure (hypertension), atrial fibrillation, angina, myocardial infarction (a heart attack), and ventricular arrhythmias. Beta blockers will control your heart rate, blood pressure, and disarythmias. The side effects of beta blockers are BROCHOSPASM! They make you wheeze. So you see here, one cancels the other out.

It appears this is whats happening to you. you're reacting to your beta blockers and the albuterol your taking is refractory to treatment. In simple tearms....it ain't workin'! But there is good news. There are alternative meds to get around this. You may want to ask your doctor about using Albuterols "sister" drug. This is called Atrovet (Ipatropium Bromide) It too is a bronchodialator however works in the lungs a bit differently. the only draw back with Atrovent, it is not considered a "rescue inhaler". Unlike Albuterol, it is not fast acting for those times when you feel tight-tight-tight and need that quick fix.

There are also alternative meds to the beta blockers. They are called Calcium Channel Blockers. Some names you may want to throw at your doctor are: Diltiazem (Cardizem, Dilacor) and Nifedipine (Procardia, Adalat).

Now, your condistion could very well be exacerbated by your current therapy. However, be sure to take notice how often and when you need your albuterol. Did you do anything to axacerbate your wheezing like come in from the cold? Play with the cata nd dog? Were you near cigarette smoke? did you just dose yourself with your heart medication. This is very important so as not to stray away from the best possible therapies your doctor needs to give you.

I hope this helped. If you have any other questions, feel free to ask! (I love this stuff!)

-Andy, RRT,CPFT

[kate38]

Andy,


Thank you,I really appreciate you answering my questions.

I was taking labatalol,had to go off of it do to severe breathing problems,switched to metoprolol 250mg continued to have breathing problems,using lots of albuterol,I had to be put on prednisone.Went to a follow-up appt with cardio he reduced metoprolol to 100mg,so far I seem to be doing ok.He mentioned somthing about it being more beta selective at that dosage.




Have a Merry Christmas!!
Thanks again,for your help.
K

[AndyRRT]

Albuterol is non-adictive. I tell my patients to use it as prescribed and as needed. As a matter of fact, Albuterol is a relatively benign drug aside from some minor side effects including a slightly elevated heart rate and the jitters. If you have no underlying cardiac disease....don't worry about a thing.

In the midst if an asthma attack, I will treat my patients with double and triple treatments at 3-4 times the dosage. The idea is to saturate the beta receptors in the lungs that react to the bronchdilitation effects of the drug. YEs, they get a slightly elevated heart rate and get the shakes...but it will avert intubation and mechanical ventilation.

If you are finding yourself using the medication more often that usual, tell your doctor. He may want to do some tests on you and prescribe additional meds.

Andy, RRT,CPFT

[kate38]

Hello,

Andy,

I use albuterol and few other meds for asthma. I take a beta blocker for hypertension,I was just wondering if you could tell me how exactly beta blockers cause problems in asthmatics.The reason I'm wondering is the beta blocker i was on,caused severe problems with my asthma.No matter how many puffs of albuterol I took, nothing happened.

Have a Merry Christmas
K