why is albuterol a prescription drug?

[mopinko]

ferchrissaakes. it took 3 hours this morning to get an inhaler for a wheezing child. who was wheezing last night, but had to wait till morning. (i wanted to take him to the er, but he wouldn't go. he is 15. i could have clubbed him over the head and dragged him, i guess.....)
why in the hell do you need a prescription for a medicine like this??

[flamingyouth]

1. I have no idea but have wondered the same thing myself.

Maybe it's because it can elevate your heartrate if you overuse it. I don't know. I'm sorry for you - hope he's feeling better today.

(I try to keep an extra one around my house for emergencies like this after one particularly awful middle-of-the-night asthma attack. As the doctor if he/she will give you a few refills - they keep a year or so.)

[mopinko]

2. he has rarely needed it.

but is getting worse. we see the pulmonologist in a couple of weeks.
the thing is that the over the counter stuff is dangerous. albuterol rarely is.
he is feeling better. but geez.

[Warpy]

3. Drug interactions plus

cardiac implications. People using it need to be monitored for signs of cardiac instability and the pharmy needs to monitor what other drugs a patient is taking to watch for interactions.

However, for kids with no indication of cardiac disease, there should be a "standing order" sort of prescription that is good for at least a year, with maybe a limit on the number of inhalers per month. (If you start using them too often, you get rebound and you're in big trouble)

I've persuaded my doc to write all my prescriptions like that except for the narcs (the DEA would start leaning on him) and he has no problem with it. If your son is an infrequent user of inhalers, this might be a solution. Just remember to get the order renewed every year when the kiddo goes in for his checkup.

[REP]

4. I Can Get An Emergency Inhaler Without A Prescription

To be more accurate, without a renewal; I have been prescribed albuterol for about a thousand years but use it so infrequently that I either lose them or have expired ones when I get a URI and need!!! one. The pharmacy will give me a new one and call my doc for a new script. I don't know if that's standard procedure, but something in the back of my sinus-infection wobbly mind makes think I remember that it is.

[WestHoustonDem]

5. Many pharmacies will do that with prescriptions if

you have an established relationship with them.

[Warpy]

6. Some pharmies will do that for you if you've been a customer

for a very long time and they have reams of old drug profiles on you, call the doc and chase the scrip later. I've had them do that for me at Wally World (of all places) when I've needed a prednisone refill and the doc is out of town.

It depends on the pharmy. You can't walk into a drug store cold when they've never seen you before and expect an emergency inhaler. You have to go to an ER.

[mopinko]

7. the regular ones would have

i go to my local grocery store pharmacy for just this reason. but i got the part-time guy that doesn't know me.

[NorthernSpy]

11. actually, there's NO valid reason for *inhaled* albuterol being rx-only

cardiac implications. People using it need to be monitored for signs of cardiac instability and the pharmy needs to monitor what other drugs a patient is taking to watch for interactions.

Cardiac problems and drug interactions are very, very unlikely for inhaled albuterol at the recommended doses. It's a selective beta-2 agonist, and its general lack of cardiac effects is why it replaced the older, non-selective bronchodilators such as the "proterenol" series.

As it happens, the OTC inhalers are good ol' epinephrine, which is about as nonselective as you can get, affecting not just beta-2 receptors, but beta-1 and alpha receptors as well. Epinephrine is a direct cardiac stimulant, and Primatene Mist could theoretically cause problems for someone with an underlying heart condition.

I'll hasten to add that I'm not bashing Primatene. I'm glad it's available. It's helped me out on numerous occasions. For the uninsured, it's usually the only game in town. But apart from emergency treatment of anaphylaxis (in which epinephrine, not albuterol, is the standard rescue therapy)*, albuterol is generally a much better choice for rescue inhalers. And I think that everyone who needs it should have unimpeded access to it.

Let's face it. We have a LOT of uninsured and underinsured people in this country. And a lot of them have chronic medical conditions that they are forced manage all by themselves, as best they can. Too many safe, useful medicines have been put completely out of their reach with little or no real justification.



*A person lacking access to an Epipen or other epinephrine injection might possibly have better luck surviving long enough to get to the hospital if they have inhalable epinephrine handy. This is not really recommended, except perhaps on the 'better-than-nothing' principle.

[mopinko]

8. turns out he has pneumonia.

the albuterol helped a little, but by saturday night he was a lot worse. tried to get him to go to the hospital, but he wouldn't. by sunday morning he was not resisting. so, zithromax, and no school.

[flamingyouth]

9. Yikes! How scary.

Hope he feels better soon!

[mopinko]

10. pretty hard to scare me.

fortunately dad is able to step in so that i can still work in the ill. primary tomorrow.