The short-acting beta2-agonist albuterol sulfate has recently become available as a large-volume (20 mL), preservative-free concentrate (albuterol inhalation solution 0.5% – Nephron Pharmaceuticals) that can be used to prepare solutions for administration of continuous nebulized albuterol (CNA). CNA is commonly used (off-label) for acute treatment of severe asthma exacerbations in hospitalized patients, particularly children. Many hospitals have been using a 20-mL multidose bottle of 0.5% albuterol that contains the preservative benzalkonium chloride (BAC) for this purpose. Until...

The FDA has approved Airsupra (AstraZeneca), a metered-dose inhaler containing the short-acting beta₂-agonist (SABA) albuterol and the inhaled corticosteroid (ICS) budesonide, for use as needed for treatment or prevention of bronchoconstriction and to reduce the risk of exacerbations in patients ≥18 years old with asthma. Airsupra is the first combination of a SABA and an ICS to become available in the US. It is not approved for use as maintenance therapy.

View the Table: Correct Use of Inhalers for COPD

The goal of asthma treatment is to control symptoms, prevent exacerbations, and maintain normal lung function. Management of acute exacerbations in the emergency department is not discussed here.

View the Comparison Table: Inhaled Drugs for Treatment of COPD

View the Comparison Chart: Correct Use of Inhalers for Asthma

View the Comparison Chart: Some Inhaled Drugs for Treatment of Asthma

The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce mortality. GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines for treatment of COPD were updated recently. Treatment of acute exacerbations is not discussed here. Drugs available for treatment of COPD are listed in Tables 1 and 3.