Contributor: Aaron Lessen, MD

Educational Pearls:

What is a Rescue Inhaler?

A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack.
Historically albuterol (Short Acting Beta Agonist (SABA)) monotherapy has been the mainstay rescue inhaler. This is because albuterol works fast and is relatively cheap.

What are Combination Rescue Inhalers?

Combination rescue inhalers contain a fast-acting bronchodilator as well as an inhaled corticosteroid (ICS)
The steroid helps to reduce some of the chronic airway inflammation that is worsening the asthma attack and can help to prevent future attacks
Examples include budesonide-formoterol and albuterol-budesonide
Global Initiative for Asthma (GINA), states that combination therapy is now the preferred reliever for adults and adolescents with mild asthma

What are the drawbacks of Combination Rescue Inhalers?

These inhalers are generally more expensive than just using a SABA inhaler which can be a barrier for some people
Improper use can also lead to conditions like thrush due to the addition of the steroid

References

Krings JG, Beasley R. The Role of ICS-Containing Rescue Therapy Versus SABA Alone in Asthma Management Today. J Allergy Clin Immunol Pract. 2024 Apr;12(4):870-879. doi: 10.1016/j.jaip.2024.01.011. Epub 2024 Jan 17. PMID: 38237858; PMCID: PMC10999356.
Papi A, Chipps BE, Beasley R, Panettieri RA Jr, Israel E, Cooper M, Dunsire L, Jeynes-Ellis A, Johnsson E, Rees R, Cappelletti C, Albers FC. Albuterol-Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma. N Engl J Med. 2022 Jun 2;386(22):2071-2083. doi: 10.1056/NEJMoa2203163. Epub 2022 May 15. PMID: 35569035.

Summarized by Jeffrey Olson, MS3 | Edited by Jorge Chalit, OMS3

Episode 954: Combo Rescue Inhalers - New Guidelines

Emergency Medical Minute