Hello. My Auntie is 80 years old. She has advanced Alzheimer's and dementia. She is wheezing quite a bit when breathing at the moment. She has a ventolin inhaler. A student nurse who helps to care for my Auntie has said that we are probably best giving her the inhaler every four hours for the next few days and in her opinion, at least 4-5 puffs. Is this dose safe?
Thank you x
If this is unusual for her and has been going on for more than 1-2 days, I would get a doctor to see her and possibly see about steroids or a preventer, if it's asthma. I suppose it's possible at her age to be using it for another reason with different guidelines.
I would be hesitant to give out advice without knowing more. That said, I use 2 puffs to relieve symptoms and if it doesn't improve take another two and if that doesn't work then treat it like a more serious attack. Unless it's a severe attack (unable to speak in sentences) where I use 4 initially and then one every minute for 10 minutes while sorting out an ambulance.
That said, my amber zone does allow 12 puffs of ventolin (6 lots of 2) each day, 4 hours apart. Though, it's not the sort of drug to be rationed if you need it - but if it's not lasting 4 hours (and you don't have an alternate plan) then you really need to be seeing an asthma nurse or a doctor.
Thank you so much for your reply, Paradigm. My Auntie's Doctor is calling to see her tomorrow to assess her breathing.
I have no wish to be cruel, but at that age with those problems, if the ventolin gives her relief does it matter how many times she has it.
Problem is overuse can cause a heart attack, so I think a docs assessment is safer and maybe a preventer will be in order.
Thank you for your reply Lynneypin. That's exactly what I have read about overuse of inhalers. My poor Auntie has enough to contend with without her inhaler doing more possible damage than helping her. Her Doctor is calling today to assess her breathing. Thanks again.
Hope that your Aunt's doctor was able to help. Even with older people the quality of life is so important. I love that you care about her enough to ask questions and work out what is best for her!
I hope that I have someone like you, Donmaharia, looking out for me if I ever need it. xx
Thank you for your kind comments, Strongmouse. My Auntie is still wheezing a bit but but not as badly now. Got to keep a close eye on her breathing and take it one day at a time x
It is overuse of inhalers over a long time.
I suppose the difficulty is that we don't know what other medications she could be taking, which might also be putting her heart rate up or if she has some underlying difficulties - plus it's likely that she can't communicate side effects much, or symptoms from overuse could be upsetting.
Significant reduction in Ventolin inhaler use after Astra Zenica Covid vaccination. 
Order of inhaler use
Inhaler adherence/use your spacer
Breath activated inhaler
