salbutmol how much is to much?

[yaf_user681_4328]

Sorry for silly question, but how much is to much?

and if it last for less than 4 hours is that ok?

is 10 puffs through a spacer the same as a nebuliser?

lots of salbutmol use at the mo

think it's the weather

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I've always thought max before seeking help is 10 puffs (individually) through a spacer leaving a minute or so between each puff.

Weather a pain in the backside for a lot of us at the min ... I'm struggling too, don't like the salbutamol though cos a lot of it makes me shake!!

Feel better soon

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If you need to take salbutamol, then take it. If you think you've taken too much and still need more then take more and seek medical help through A&E, OOH or GP. How much is too much is going to be different from person to person, so if you want to find out how much is too much for you then ask your nurse/GP/cons.

If salbutamol is not lasting 4 hours then this could be a sign that preventors need increasing temporarily (or maybe longer).

Quite a few doctors tell me (and I guess many others too) that taking 10 puffs of reliever 1 puff at a time through a spacer is as effective as a neb. Personally I don't agree, I find that if really struggling it's difficult to do and not as effective as a neb.

I hope you're feeling better soon xx

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Everyones point for needing to seek help will be different according to their agreed action plan. I use a nebuliser every day without needing to seek help.

Many docs say that 10 puffs is the same as a nebuliser and I wish they wouldnt... 10 puffs of 100mcg = 1mg. A nebulised salbutamol is 2.5mg or 5mg so 2 1/2 or 5 X the dose. Perhaps what they should say instead is that in their view, the effects would be the same.

For me, that is not the case. So whilst you need to have a plan if when you should get help, you need an awful lot of puffs to get to the same dose as a nebulised dose.

Feel better soon

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I've been reading the Asthma UK publications which state if 10 puffs in 10 minutes is not helping, then you should ring 999. However, my own doctor and our OOH and NHS24 have all told me it's impossible to overdose on it and to keep using it as much as is needed.

It's so confusing I wish there were clearer guidelines/advice

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I think there are two separate issues here though. One is about getting help appropriately in case things deteriorate further, the other is about use of ventolin. What they don't want people to do is have 50 puffs of it and not seek medical help because that's risky (deterioration). I would think that's why they have a guideline, not because the drug is unsafe. Nebulisers are way higher doseage and many, including me, use those at home a few times a day.

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I totally am with you. My frustration is I had my 4yr old daughter at over 20 puffs within 30-45minutes earlier in the week but the OOH doctor insisted it wasn't asthma and sent us home.

I wish they all had the same thinking

[yaf_user681_4328]

Big thank you

my GP is of the veiw there is no such thing as to much salbutmol.

A&E don't think coughing is an asthma symptom, I asked a firend and for A&E to trat you have to leave it quite late.

once I was sent from my GP to A&E who said should have gone to you'r GP ! (where I had just come from)

very unjoined up thinking

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I think more important than a fixed number is being alert to any 'not normal for you' situation.

So - if you have asthma that only ever needs a few puffs, and suddenly your reliever is making no difference, then I'd say seek help - because you have no way of predicting what is going to happen next.

Personally I regularly have to use many, many puffs in a spacer when I have bronchospasm (I also have a home neb, and as NF says, I don't find them to be identical, though sometimes I prefer how concentrated you can get the MDI-spacer to be).

What's 'not normal' for me is for my symptoms to stay very bad for long. I tend to have very severe acute attacks that resolve rapidly. So after an hour or two I add steroids, and it's absolutely not normal for me to still be struggling after 24 hours on the steroids. So that has been an indicator in the past that I needed something extra.

What I would say is that as long as you are struggling, don't stop taking the reliever - but if it's an unusual pattern for you, seek help as well as keeping taking it (through a spacer, obviously).

The part that doctors often fail to appreciate is that many of us have had an experience that has taught us that one of the early symptoms of hypoxia is that you start to lose your judgement. On the couple of occasions when I was most unwell with my asthma I actually felt pretty relaxed and was confident that I was OK - but my sats turned out to be awful. So, when I'm struggling beyond 'normal for me', my partner can't take my word for it that I'm actually doing OK - nobody should. At that point you need empirical data, and that's not just PF because personally I can 'blow' 250 after fully exhaling, just by moving the air in my windpipe! (Ex brass player).

Something I've learned the hard way is that because A&E is pollen-free, temperature-and-humidity-stable and you're likely to be sitting still and not doing anything for a while before you see the doc, usually A&E doctors get to see you at the absolute most stable you can be with your symptoms at the time. If you have the capability, get some footage on your phone of you struggling before you go in. It all helps to fill them in.

One thing worth remembering is that because of the impact of salbutamol on electrolytes, you are likely to have symptoms that look a lot like physical anxiety if you've take a lot of salbutamol. That's on top of the very sensible, logical distress at being unable to breathe properly! If docs start going down the 'panic/anxiety' route, ask them to check your electrolytes before they make that assumption.