salbutomol - does anyone else find it extremely unpleasant and unsettling?

[usernamefromhell]

My DD (8) has suspected asthma (occasional very severe respiratory reactions to viral infections, not atopic and totally asymptomatic other than following a cold, thus has been very difficult to get a diagnosis). She takes salbutamol when she has flare-ups, on doctor's orders.

She was admitted over the weekend following an episode and discharged yesterday with prednisolone and ordered to taper down from 10 puffs of salbutamol every four hours.

Have now tapered down to 8 every four hours.

I'm following medical advice but I can't stand the effect it has on her -- its not only the hyperactivity and jitteriness but her personality seems to change on it, she becomes almost aggressively hyperactive and moans in her sleep for hours and hours in a way which is quite distressing after she's had it. I've read up on it and I know its a life-saving drug which is effective if used properly but I can't help feeling that if used outside of an acute episode it actually makes things worse.

Has anyone else had this experience? I don't want to ignore medical advice but all my instincts are screaming at me not to use it -- I hate it.

As I understand it - Salbutamol acts on the beta-adrenoceptors which can be found all over the body. They are found in the lungs, which is where the salbutamol is aiming for. However, once absorbed, it has an affect on every beta-adrenoceptor in the body - including ones in the fingertips (shaking and twitchy fingers) and in the heart (racing heart, palpitations - imagine if beta blockers stop the overworking of the heart, salbutamol is a stimulant that works on the same tiny receptors, so increases the work of the heart).
So it works very well for what it’s intended to do, in the lungs, but unfortunately does have an effect on all susceptible adrenoceptors around the body.

Tony I have done, endlessly, with numerous different doctors. They all say basically the same thing which is that yes the side effects can be unpleasant but during or after an acute attack you have to use it.

Besides which there isn't, to my knowledge, anything else you can take outside of a hospital setting for acute attacks.

For people who keep saying it's a massive dose, I assume she is taking it via a spacer because she is young. NHS guidelines is 10 puffs every 4 hours after an episode, weaning down every 24 hours.
Using a spacer means they don't take in as much.

luckyrabbits yes that's correct.

Leads nurse here. Salbutamol does make children jittery especially if they are having slit. But the personality changes are almost certainly the steroids. I felt like that when I had methylprednisalone
10 puffs is a standard dose for a flare up.

toddlertea thank you. This all sounds sensible.

The physical symptoms are normal for high dose salbutamol. Psychological symptoms are much more likely to be due to the prednisolone (affectionally known as ‘roid rage’).

My youngest had a number of admissions up to the age of 3.5 and would be on 10 puffs per hour or nebuliser and would get terrible jitters. Does wear off. He's been on a preventer for 2 years and he now copes much better and so far no more admissions.

Hopefully your little one will grow out/even out on preventers. Terrifying when they're poorly though

10 puffs every 4 hours is normal dose after an acute episode. Weaning down gradually on the salbutamol, while taking oral prednisalone to kick in.
I’m not sure why everyone everyone is saying this is huge?? Yes the normal dose is 2 puffs, that should be effective for 4 hours. But if there’s an exasperation then 10 puffs four hourly is the way to go.

Luckyrabbits - I hadn’t heard that a spacer means they don’t take as much?? I believed that using a spacer meant that the dose was more effective in getting deep into the lungs, and exactly where the meds were needed?