A New Look At Your Rescue Inhaler

Implications for asthma treatment
These findings inform the current controversy surrounding the suggested harmful effects of long-term use of long-acting beta agonists (LABAs, e.g. salmeterol, formoterol) in asthmatics. This is the paradox: LABAs improve asthma symptoms by opening up airways on the short term yet may put patients at risk of worse asthma down the road by making asthmatic airways more sensitive. Even more tantalizing from a scientific point of view is the possibility that blocking beta adrenergic receptors may be beneficial in humans as it seems to be in mice. This paradoxical approach applied to the same biochemical pathways has been used in the treatment of heart failure in humans.

For now, these findings are provocative but not ready for prime time in terms of changing asthma treatment. By no means am I recommending that my patients toss out medications that make them feel better based on this research. However, the findings shed light on a possible mechanism by which medications that are helpful in the short term could be harmful in the long term, especially if used injudiciously and without careful monitoring.