NN,

I am sorry you have been down. Certainly everyone in here has been through
at least one of those periods.

People posting generally only quote the studies which support them, so what
you read here isn't always very balanced. You can go to Pubmed and see what
your own literature searches reveal, but I have never seen anyone collate
that information (someone likely has - the drug manufacturer!, we just
aren't privy to it). Just remember, when it comes to doing literature
searches, things are almost never cut and dried. Each side can quote studies
that support their postition.

I believe in these links, with the back and forth discussions (politely
stated) the regular medical establishment's point of view and the altmed
point of view (well, two groups anyway) are represented.  If you read
through the threads I provided, you will see why each side sees holes in the
other side's contentions. And they do sometimes post studies to support
their claims. Some of the studies are a bit dated, so watch out for that.

If you ever get around to a detailed literature search, let us know what you
find.

Joy

their own

I think just making the blanket statement that "albuterol is
bad for you" is obviously wrong. In low doses of one or two
puffs every once in a while I think yuo would be hard
pressed to find any serious adverse effects supported by
scientific literature other than that of a small minority of
people that will experience an increase in heart rate and
possibly feel jittery. That is not to say that it does not
have some issues.

What I think people point to mostly is the stuff Joy
mentions regarding regular use of high doses of it. At one
time it was common for docs to prescribe "standing doses"
given 4 times per day (just take it that often regardless of
symptoms). The practice became markedly less common after it
was noted that people with albuterol prescribed this was
died more often. It was never determined if this observation
was due to the need for frequent dosing refecting poor
control of asthma (i.e. they died of the disease and not the
drug) or if it was from abnormal heart rhythms triggered by
the albuterol (i.e died of the drug - which is theoretically
possibly). I think most experts assume there was some
component of both but would be hard pressed to say how much
of each.

A more recent study looked at kids with asthma and the drug
salmeterol which is a long acting version of albuterol. In
this study it was found that adding salmeterol without a
steroid produced adverse events while adding it with a
steroid was helpful. This study was able to show that at
least most of this effect was due to poor control of the
asthma.

Another issue, also mentioned by Joy, is that with regular
doses of albuterol the effectiveness of the drug decreases
(called "tachyphylaxis"). This happens because if the
receptors are stimulated too much the cells literally remove
some of them from the cell surface. Taking steroids (inhaled
or oral) causes the cells to put more receptors on the cell
surface and so can help combat this.

In addition to stimulating the heart high, doses of
albuterol can also cause electrolyte abormalities (mostly
low potassium) but the doses needed to do this would be hard
to achieve by inhalation (similar drugs are given IV for
several different reasons).

Lastly, athlete's abuse of a similar drug, clenbuterol, has
lead to some speculation. This drug has been shown to reduce
the breakdown of muscle tissue and so is being abused as an
anabolic agent. Some people speculate that the increase
diagnosis of asthma in elite athletes stems from attempts to
hide illegal use of this drug. Personally, I'm sure it is
happening but the pattern of athletes getting the diagnosis
(more swimmers and long distance runners than strength
athletes) suggests that at least some of the increased
diagnosis is from real disease (although they may be looking
for the dual effect on their respiration). As always, when
elite athletes die people presume that ilicit performance
enhancing drugs may have something to do with it (as do I)
and many of these athletes have been taking clenbuterol -
but rarely that alone. Again, you would have a difficult
time achieving the doses we are talking about here with an
inhaler.

Basically, if your asthma is well controlled and you are
using rescure doses infrequently (not several times a day)
the medication is unlikely to be dangerous other than some
side effects of jitteriness and fast heart rates. If you are
requiring it often then you need to have a talk with your
docs about the poor control of your asthma.