Albuterol Inhalers for Asthma

How the Drug Is Used to Alleviate Airway Restriction

Albuterol is an inhaled medication classified as a bronchodilator that quickly relieves the symptoms of asthma. It works by relaxing the smooth muscles of the lungs, usually within minutes. For this reason, it is often referred to as a rescue inhaler.

There are currently four brands approved in the U.S.:

  • Proair
  • Proventil
  • Ventolin
  • VoSpire

Each is essentially identical to the others (with the exception that Ventolin has a dose counter). On average, each will deliver 200 inhalations per canister and 108 micrograms of albuterol sulfate per puff.

Small boy with inhaler
Jose Luis Pelaez / Getty Images

How Albuterol Works

Smooth muscles are found in the hollow organs of the respiratory, gastrointestinal, urinary, and reproductive tracts as well as the blood vessels of the circulatory system. They differ from skeletal muscles in that they are not under voluntary control.

During an asthma attack, certain environmental triggers (such as pollen or dust) will cause the immune system to respond abnormally, leading to:

  • The tightening of the smooth muscles of the lungs (bronchoconstriction) and the restriction of air flow
  • The overproduction of mucus and the clogging of air passages
  • The inflammation and swelling of the air passages

Albuterol works by activating a molecule on the surface of smooth muscles called a beta-2 adrenergic receptor. This effectively blocks the activity of two substances needed for muscle contraction (myosin and calcium) while preventing certain white blood cells from secreting inflammatory chemicals into the bloodstream. The dual action both relaxes the lungs while alleviating the inflammation that can cause air passages to further narrow.

Side Effects

As with any drug, albuterol is known to cause side effects in some users. The most common include headaches, heart palpitations, chest pain, dizziness, shakiness, nervousness, sore throat, and runny nose. Less commonly, a person may experience a rapid or abnormal heartbeat, flushing of the skin, sleep disturbances, or mood changes.

If used excessively or for long periods of time, albuterol can lead to low potassium levels (hypokalemia) which may be serious in persons with kidney failure.

How to Use an Albuterol Inhaler

Albuterol inhalers are relatively easy to use. A spacer (an attachment that increases the distance between the mouth and mouthpiece) is recommended as it ensures the medication goes deeper into the throat rather than being dispersed in the mouth.

If you are using the inhaler for the first time or have not used it in the past 14 days, you will need to prime it by shaking the canister and pressing it down four times to clear the opening.

You would then follow these five steps:

  1. Exhale completely through your mouth.
  2. Place the end of the mouthpiece into your mouth, closing your lips tightly around the opening.
  3. Inhale deeply as you press the canister down for one puff.
  4. Hold your breath for 10 seconds. remove the inhaler, and exhale slowly.
  5. If you require more that one puff, wait for one minute before repeating the steps.

It is also important to clean the inhaler at least once weekly as they tend to get clogged. To do so, remove the canister from its holder, rinse under warm water for 30 seconds, and allow it to dry overnight.

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Article Sources
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  1. Merck Manual Professional Version. Albuterol. Updated July 2019

  2. PROAIR HFA (albuterol sulfate). Highlights of prescribing information. Revised February 2019.

Additional Reading
  • Price, D.; Rigazio, A.; Buatti Small, M. et al. "Historical cohort study examining the comparative effectiveness of albuterol inhalers with and without integrated dose counter for patients with asthma or chronic obstructive pulmonary disease." ​J Asthma Allergy. 2016; 9:145-54. doi:10.2147/JAA.S111170.