If you have a serious asthma attack (exacerbation), your doctor may prescribe a short course of oral c orticosteroids. When used orally for less than two weeks, the side effects of corticosteroids are less likely, but when used for many months, they can have a serious and permanent effect. After the severe symptoms of your asthma attack have been successfully treated and controlled, your doctor will work with you to minimize your need for prednisone in the future. Faithfully taking an inhaled corticosteroid every day is the most commonly successful method to do this.
A neb treatment has 2500 mcg of Albuterol, while two puffs of an MDI is 200 mcg of the same medicine. The increase in heart rate often noted with the neb reflects the higher dose. So how do we explain the often reported similar subjective and lung response in patients regardless of delivery method ? I’m not sure, but I wonder if the neb dose could be lowered without sacrificing response for those instances where the MDI is effective. Or approach nebs like we do with an MDI: start with 500 – 1000 mcg, and if desired take a second treatment.