Ventolin overuse

[vinny808]

Has anyone had any experience with patients who use and pickup ventolin inhalers every 6 days or so? I’m just a floating pharmacist but the times that I’m at this particular store and come across this pt I always counsel him about the risks of overuse. I’ve finally gotten through to him and convinced him to seek therapy change or a different doc who will change his therapy. I also called and faxed the doc messsages many times. The pt is in his 70s, works out of town in the woods working 18 hr days. He claims he’s been using ventolin this way for decades. Has anyone ever seen this before?

He’s also on symbicort 160 2 puffs bid and claims it doesn’t help.

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[pharm B]

Is the albuterol even having an effect at this point? Talk about extended chronic overuse.

 

[Sparda29]

Has anyone had any experience with patients who use and pickup ventolin inhalers every 6 days or so? I’m just a floating pharmacist but the times that I’m at this particular store and come across this pt I always counsel him about the risks of overuse. I’ve finally gotten through to him and convinced him to seek therapy change or a different doc who will change his therapy. I also called and faxed the doc messsages many times. The pt is in his 70s, works out of town in the woods working 18 hr days. He claims he’s been using ventolin this way for decades. Has anyone ever seen this before?

He’s also on symbicort 160 2 puffs bid and claims it doesn’t help.

His doc should be putting him on Singulair 10 mg daily.

 

[CetiAlphaFive]

Has anyone had any experience with patients who use and pickup ventolin inhalers every 6 days or so? I’m just a floating pharmacist but the times that I’m at this particular store and come across this pt I always counsel him about the risks of overuse. I’ve finally gotten through to him and convinced him to seek therapy change or a different doc who will change his therapy. I also called and faxed the doc messsages many times. The pt is in his 70s, works out of town in the woods working 18 hr days. He claims he’s been using ventolin this way for decades. Has anyone ever seen this before?
He’s also on symbicort 160 2 puffs bid and claims it doesn’t help.

Yup.
I had almost exactly the same situation.

I would counsel *every time* and constantly ask his wife picking up the script to have him come in so I could see what the problem was.


My thinking was that there was no way he was using it correctly. I also faxed and called his doctor's office multiple times with no results.

Just document everything and try to help the Patient the best you can.

 

[BidingMyTime]

My thinking was that there was no way he was using it correctly. I also faxed and called his doctor's office multiple times with no results.

This, I would also vote for not using it correctly.

OP, maybe you suggest a spacer to your patient, and see if that makes a difference for him.

Also.....does anyone know why albuterol inhalers are becoming popular among people using drugs illegally? Is it just they are ruining their lungs with their meth cooking, or is it something else?

 

[lord999]

Status asthmaticus anyone? Also, albuterol is a pretty good weight control drug, which is why it never received consideration for OTC status although it's superior to inhaled ephedrine. Probably could use a spacer or a nebulizer solution if he's using it that much, but also, it is actually possible to use q2h and q1h over a short period of time.

But hey, he's pretty set in his ways, so there's not terribly much you can do to change habits until he puts himself in the hospital from his lifestyle. You did your part if you documented the absurd refill schedule.

 

[Sine Cura]

Reselling inhalers is not out of the question. I have a guy who even had a PA done for Proair (non-formulary) so the PA justified chronic use ("intolerance" to steroid inhalers; no Singulair)