Ask the Pharmacist: Asthma inhaler reduces scary breathing problems

Suzy Cohen

If your child must undergo a tonsillectomy, there is important research newly published in JAMA Pediatrics that I’d like to share with you today.

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Years ago, tonsillectomies were performed due to recurrent infections, but today, the reason for this surgery is more likely to treat obstructive sleep problems that cause coughing, shortness of breath, wheezing and bronchospasm. 

In adults, breathing difficulties occur during sleep and are quite uncomfortable and scary. The symptoms of SDB range from loud snoring, to complete blockage of the breathing airways (during sleep) termed sleep apnea, or obstructive sleep apnea.
In children, tonsillectomies are common surgical procedures and not considered high risk. Unfortunately, half of the children experience a problem during or right after the procedure that has to do with their lungs, ability to breathe with comfort and other symptoms. 

Asthma symptoms often worsen during the winter months due to the cold and dry weather.

For example, tonsillectomies can frequently cause problems ranging from coughing, bronchospasm, laryngospasm and airway obstruction to oxygen reductions in the blood, coughing, and stridor, the term for wheezing which occurs due to a blocked windpipe or larynx. These symptoms are extremely frightening for both the child, and the doctor, not to mention the parents if are present during an episode. My hope today is that my information allows your child to get through the procedures without these terrifying problems.

Researchers conducted a study to see if they could help kids and get to the bottom of all of this. So, they gave half the study participants two puffs of a popular asthma drug called albuterol sulfate (a.k.a salbutamol sulfate). The other half received a placebo, meaning a non-medicinal inhalation. The experts wanted to see if the asthma drug could serve as a pre-treatment drug to lower the risk of children experiencing peri-operative breathing difficulties during their tonsillectomy.

Sure enough, it helped, just two actuations of albuterol administered via inhalation and taken shortly before anesthesia (and before the surgical procedure) could help reduce the risk of these adverse events that surround tonsillectomies. The placebo group experienced a lot of breathing problems, almost half of those kids had an issue. In the albuterol-treated group, only 28 percent of kids had an issue. This is quite significant. The researchers concluded “Premedication with albuterol should be considered for children undergoing tonsillectomy.”

If you are the parent of a child that requires a tonsillectomy, be sure to tell your doctor about this research, don’t assume they know it because it just got published literally days ago. 

It also begs the question if albuterol (which is cheap and easy to get by prescription) could be helpful for other people with breathing difficulties, such as apnea. The answer is no. There isn’t any clinical evidence to support the use of this asthma drug for apnea, or loud snoring, and in fact, albuterol is stimulating, and it may interfere with restful sleep. Albuterol is a quick-relief inhaler designed primarily for asthma as a rescue aid. It's not an apnea drug. If you have apnea, use a CPAP device.

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Suzy Cohen is a registered pharmacist. The information presented here is not intended to treat, cure or diagnose any condition. Visit