Hi all. Does Salbutamol usually cause faster breathing, or other side effects after taking 6 - 10 puffs within 15 minutes due to an Asthma attack?
I have had an attack which wasn’t relieving after my usual 2 sets of 2 puffs over 10 minutes. So I started to have 1 puff every few minutes.
However by the time I’d had 7 puffs, my breathing was very fast- I couldn’t speak, was dizzy, lips tingling, my whole body was having tremors and I went freezing cold to the touch. My husband called an ambulance and they did all checks and told me it was no longer an asthma attack but had turned into anxiety attack! And some of the symptoms I was having was a side effect of the Salbutamol along with panic.
This was a relief but I am now scared to use my Salbutamol inhaler too much if I have an attack again as it feels like it made my breathing worse. I understand it could of been panic but it didn’t feel like panic it felt like the asthma attack had continued- so strange.
Has anyone else had this? If so is there a different medication to try for reliever inhalers?
Many thanks!
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LRLR
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The symptoms you experienced can be a sign of hyperventilating - which can be part of anxiety attacks but equally can happen linked to asthma. It's basically breathing too fast which is common in an asthma attack. But when that happens toocarbon dioxide is breathed out more quickly which can cause those symptoms. So it's not having had too much salbutamol that would have caused it as such, more the way you were breathing - not necessarily something you could help at the time.
In theory, with an asthma attack, the salbutamol would work, opening the airways and regulating the breathing. If it's not helping it's possible it's not an asthma cause for the symptoms - or can be an indication that help is required if it is asthma, which is what you need. It can be so hard to know sometimes so you did the right thing - whether it wasn't asthma triggering it this time or it was but actually you managed to sort it with the ventolin will remain unknown, but I don't think you could have done anything differently - if it feels like asthma normally does to you then you can't ignore it.
Hi thank you yes it does help a lot that has given me clarity after an evening of confusion!So yes that must of been what was happening by the end I was hyperventilating and could not control my fast breathing it was getting faster and faster and I could not even speak a sentence to the 999 operator. My breathing regulated when the paramedic told me my statistics were all fine.
I know asthma was the initial trigger- it began as usual sudden blocked nose and coughing before hand. My breathing was shallow and fast and the inhaler wasn’t relieving it like usual. So it could be possible my asthma (shallow breathing) made me hyperventilate- the inhaler did relieve the asthma but by then I was hyperventilating so didn’t feel better- which then caused panic and more hyperventilation. Using so much inhaler also caused tremors and a racing heart which the paramedics confirmed and also caused me more panic!
So, if I have an asthma attack like that again I need to learn how to not hyperventilate. I am having them more and more frequently and it is a worry as I have not got a diagnosis yet so not on preventer medication. I see the doctor at the end of the week to show her my 2 week peak flow readings. This is the 6th flare up/ attack in 2 weeks so I just hope to find out how to manage this sooner than later!
Thanks so much for your insight, I will phone the asthma nurses Monday too for help with what to do next time.
Do you think it is common or normal to hyperventilate from asthma attacks? Is this usually what happens from shallow breathing or is it more likely I was panicking too much?
Sorry for the odd question! But this is all new to me and just trying to get my head around it and what to do next time.
I’m guessing I need to breath deeper and longer during the attack whilst the inhaler gets to work, but is this physically possible when your breathing is so shallow? Have you ever had this?
I think it's really common. I've always been told to focus more on breathing out slowly, rather than breathing in deeply. I often get stuck with too much air in my lungs that I can't breathe out which then means I can't breathe in either 🤦🏻♀️. Try not to worry too much about it though, you did everything right and you will be better prepared if it happens again.
Yes I agree with Glty - very common! We do need to breathe more slowly and deeply but it's often really hard to and (for me) impossible in that acute situation.
Something that helps me in this situation is to use my Ventolin with a spacer and tidal breathing (I believe that is the recommended way to take Ventolin during an attack anyway). Of course the spacer is to help more of the medicine to get to the lungs but I find it has a secondary effect of distracting me somewhat from the anxiety of it all because I’m concentrating on breathing in and out five times through the spacer for each puffs. On a few occasions it has helped me to breathe in and out through the spacer without the inhaler attached. I don’t believe that will help the actual asthma symptoms, but may help the anxiety that goes along with an attack by causing you to breathe more slowly and deliberately. Hope you will soon be put on a controller inhaler. I think you need to push for that tomorrow because it really isn’t safe to have what is clearly out of control asthma with only Ventolin at hand. You may also need some oral steroids to relieve the initial inflammation as a result of these attacks and to prevent you having another one. Rest up today and don’t be afraid to call for help if you find you’re becoming unwell again. Remember that asthma is serious and needs to be treated as such! My asthma society nurse told me about the Buteygo breathing technique. I really haven’t looked into it much yet but perhaps you would like to - you’ll find YouTube videos about it.
Thank you for this fostairex! Yes I understand what you mean I did find I instinctively wanted to breath through the spacer as this was helping me to slow down, so I will do this next time even without the inhaler on.
Thanks for the video twinkly that is so helpful! I have watched it and actually feel like I have more of a plan as to what to do now- I tried to research myself but couldn’t seem to find anything that made sense to me on the breathing side of things.
I have also found the Buteygo technique here is the link:
He talks about hyperventilating too which makes me feel more normal and know it wasn’t all in my head! Lol
I am taking your advice Fostairex, I will push for a Gp appointment tomorrow as it seems like the flare ups are happening more often as the days go on.
I did not think my asthma was that serious-as I never have a wheeze (only when I laugh which is new for me the last few months) so although my chest is tight I think it maybe clear if that makes sense. But I am only guessing.
My peak flow recording has showed without ventolin I am between 76-80% of my personal best which I didn’t think is that bad so thought I’d be ok with just Ventolin for a bit until I see the doctor. But actually, maybe it is worse than I though as my symptoms do feel bad. I was so exhausted the first week without the ventolin and now this week with it I’m still getting attacks.
Hopefully they will see me tomorrow.
Thanks so much everyone you have helped me a lot particularly with it being the weekend and medical services closed. I appreciate it!
I still don’t have one filled in as they have told me that my asthma should be controlled before filling it in, but I haven’t got to the stage of it being controlled yet! But even without it being personalised, the information on it is very useful. It’s good to have something objective that we can measure our symptoms against - I find that I tend to under-estimate the severity of my symptoms. I think we all know the image of the classic textbook asthma attack patient and if we don’t match that - gasping for breath, unable to speak, etc - we feel like we really aren’t too bad. I have really had to work hard at recognising the signs of deteriorating asthma and the action plan has really helped with that.
Hope you get on well tomorrow. It would be interesting to hear what your GP says!
LysistrataAdministratorCommunity Ambassador in reply to LRLR
Yes definitely push for an appointment! Peak flow can be helpful (more so for some than others) but it isn't the be all and end all. It's also worth considering that if you've been uncontrolled for a while, your personal best currently may not be as good as you could do if you were better controlled.
I can see Fostairex has already posted the action plan post so won't add that. Definitely worth getting one - it should cover symptoms as well as peak flow.
I never considered that we cannot get our personal best until we have asthma controlled with preventers. I thought the Ventolin would be enough to control it but actually I see you’re saying it may be more medication is needed to get it properly controlled?
I just thought (wrongly!) the highest I can get after my Ventilon would be my personal best- currently mine is 530 ( I am 5.7ft) However, if I am 420 I am breathless just going up the stairs and struggle. This would mean I struggle being in 80% of best peak Flow. but just reading the information you have sent it says that 80% is the green zone. So this maybe is not 80% for me.
Either I do not yet know my personal best, or peak flow does not always show when we are struggling. If so I hope my Gp will realise this and I do not have to have a debate about it! 🙈
I have already thought this as I took ventolin as usual on Monday and 1 hour later I was breathless driving to work. I am sure the cold weather or the car heating was a trigger. When I took my peak flow it said 480 which is the green zone!! And probably this high because the ventolin was still in my system but I was definitely breathless and struggling. Another two puffs did sort it and took me back up to 520, but I wonder if a doctor would say I shouldn’t be struggling at 480? Or if they believe peak flow is not always accurate?
With a clear chest too I just hope I get the right treatment and I won’t be undertreated. The paramedic last night said to me- you have no wheeze and a clear chest so you’re ok. But I feel like it isn’t that simple.
I think the sharpie pens on the peak flow monitor is such a good idea!!
I hope you can get your asthma controlled soon fostairex it must be so unpleasant for you!
LysistrataAdministratorCommunity Ambassador in reply to LRLR
Yep Ventolin really is not enough. It tackles the symptoms but not the underlying inflammation and processes that are the reason you get these symptoms. If you don't tackle that you will keep flaring. There are a few people who manage just taking intermittent Ventolin, but you are clearly not one, with all this going on. And some guidelines would prefer even intermittent Ventolin users to be on inhaled steroids as a preventer - either regularly or as needed when they take reliever.
Not sure if anyone has said this yet but just to emphasise, you do not need to wheeze, or even drop your oxygen sats, to have asthma. This post about asthma vs anxiety vs breathing pattern disorders may help you: healthunlocked.com/asthmauk...
You should already be on a preventer medication, so ask your GP about it asap. Your personal best won't necessarily go up when you're better controlled - you may be hitting it already post Ventolin, and when you're more controlled you may just stay in the green zone most of the time and have less variability. But it may well be that you're never quite doing well enough at the moment to get as high as you could. As Emma's post says, there are a number of factors that affect peak flow, including age/height/gender (men get higher numbers usually because they usually have bigger lungs), or whether you did sport or singing as a child. I am a 5'8" woman with severe asthma and I have a best of 630, probably because I played the oboe for years. Trying to get that across (my predicted is around 470) can be tricky as it looks like my peak flow is great and I have even had people not believe it can be that high! The predicted really is just a population average value.Even if 520 is better than predicted it doesn't mean you might not be able to get even more if you're better controlled.
And to answer your question, yes, peak flow doesn't always reflect what's going on, and that isn't always understood well. Some doctors do understand it isn't everything, but others are very set on it. I've had a peak flow over 50% in my worst attacks (think hospital with a lot of treatment needed) but under 50% in ones that were less bad (still hospital but less bad).
I would hope that once you are on a preventer that works for you things will calm down a lot and you won't keep getting these flares. Just using Ventolin is a bit like trying to put out a house fire with a garden hose while there's an arsonist inside starting more fires! You need the police and fire service (preventer) to remove the arsonist and the stuff that keeps catching on fire. Then hopefully you won't need your garden hose (Ventolin) very often and if you do it will be able to sort the fires easily.
One final thing in a long post: if you aren't sure about anything or are lost about what to do, you can always call the Asthma UK nurses - they are lovely and happy to listen and take their time which GPs can't/don't always do. You can reach them on 0300 2225800 M-F 9-5AUK or same hours on WhatsApp - 07378 606728.
To follow on from what Lysistrata has said, some GPs are really good with asthma care and monitoring (not necessarily personally monitoring but educating the asthmatics to monitor themselves). Others are dreadful. And of course others are somewhere in the middle. But at least with the background reading in the links you'll know what should be happening! 😅
Thanks for all of this information it is so helpful! I am completely new to all this and just been trying to put the pieces of the jigsaw together the last few weeks since my symptoms came on- at age 40!
I have learnt so much the last 24 hours because of this site- you are all wonderful and so supportive you have helped me more than I can express.
Yes it’s great to be able to go to the Gp empowered with knowledge so we can have the discussions if need be. 🤗
If it helps at all, you seem pretty level headed and to making be sensible connections, given it's all new and that you're having to find your own way through it at the moment - or maybe that should be "despite being new to it..."
Hopefully the GP will be receptive and one of the good ones!
It has been a whirlwind with shocking symptoms and new knowledge!
I had no idea about this world and I feel so sorry for you guys who have been in hospital at 50%, or having ongoing, long term problems and things like that, it must be horrendous. My attack last night (probably mild/moderate) was bad and scary enough so I can see it must take so much strength and bravery to go through worse than this.
You have all really helped me a lot today I have had so many questions answered! This is such a great and supportive forum!
Hope you had success today! Just to point out re the green/orange zone - to be in the orange zone you just need to be experiencing any of the things described in the list: ie, symptoms coming back OR symptoms interfering with daily activities OR waking at night OR using Ventolin more than 3x weekly OR peak flow below 80%. As Lysistrata says peak flow isn’t always a good indicator. For me, for example, my PB is 450, and during my last exacerbation for which I required oral steroids, it never dropped below 390. So if I were to go only by peak flow alone, it would have meant waiting probably another few days at least to contact my GP, getting sicker and weaker and more exhausted from working hard at my breathing. (I do always keep a check on my PF as I am getting to know it and a drop even to 410 from 430 for a few days signals to me that things are starting to go downhill - even though that is a tiny tiny drop by “normal” standards!) Just wanted to point that out in case it wasn’t clear to you. If you’re struggling, chances are you need help even if your PF doesn’t give cause for alarm.
Hi! Sorry for the late response I did not realise you had posted!
Thanks that really helps to know what the orange zone is. I realise now that I’ve been in the orange zone for several weeks! Although peak flow might not always show it.
I spoke to an emergency doctor by telephone and text over picture of my graph- who said he could not diagnose asthma or prescribe a preventor just based on peak flow and symptoms and that I would need more tests which would take a while. This was really upsetting to hear, however he did get me in to see another Doctor for a medical examination.
Luckily this other doctor has given a ‘likely diagnosis’ of asthma based on my symptoms and peak flow graph- she said they would usually need more tests to confirm but because of Covid it’s not possible. This absolutely baffles me as I cannot think of any other possible diagnosis for my symptoms and had thought it was diagnosis beyond any reasonable doubt regardless of further tests.
However she was great, she also explained that you do not need a wheeze as you have all said and that although chest is clear it still seems like asthma. She has given me 100mcg of Clenil 2 puffs a day so I am so relieved to have been given this. I have to go back in 6 weeks for a review however if I am still in the orange zone in a few weeks I think I will go back sooner.
Just to say too; I had no idea that you could get so weak and exhausted from working hard at breathing like you mentioned. This happened to me also the other week,I was so wiped out and as soon as I took the ventolin I felt like a new person. I also spent the whole day in bed Sunday after asthma attack.
People often think of asthma as having ‘asthma attacks’ but there is so much more to it!
Thanks! Great to hear that you had a good visit to that doctor and received a likely diagnosis. It is interesting what they said about the tests. I never had any tests done to confirm diagnosis, but that was 15+ years ago and not NHS...things might be different now. Also had a family history of asthma so maybe that counted for something. Hopefully you’ll have good results from the Clenil! Yes there’s a lot more to asthma than people realise. For years all it meant for me was a puff or two of Ventolin once in a blue moon. The last two years have been a steep learning curve!
Thank goodness for the other doctor! And that the first got another to see you. The tests can help in diagnosis of course but, if you are on a good day when they're done (asthma being variable this is very possible) then the tests may be normal. Much of diagnosis should be the peak flows and symptoms.
Anyway glad you have preventer inhaler! It can take 8 weeks or so to become fully effective but by your review hopefully they'll be seeing a difference - and you will be too. Also yay they said you don't need a wheeze!! Not everyone acknowledges that. In the meantime, keep a log of symptoms/peak flows/ventolin use as hopefully symptoms and vent use will decrease over the next few weeks which adds to the likely diagnosis.
Oh I see! I thought the medication would work sooner. Well that’s good to know so I won’t start worrying if it takes a while to work. I expect I will need ventolin for a little bit then until it all calms down. Although I feel better already with clenil and have now reached 570 peak flow my highest ever! 👏🏻👏🏻
I know yayy about no wheeze!! Lol she also said she doesn’t expect to hear or see anything at all with asthma unless the person is having an exacerbation there in front of her. I thought this was also good of her.
Can I just ask, now I have reached that higher peak flow ( only got this once and can’t get it again!) should I base my action plan on that being 100%? Even though that was after a fair bit of Ventolin?
The inhaler might well start to work sooner but can take time to fully embed. Your best peak flow might well increase over time too.
I would hold off using a single reading as your best but if you get similar again then it's ok to use it. I think! It might well come though in time with your new meds.
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