MikeyBoyAz

oh, and btw. I was talking about taking in 3cc of Albutterol with an atomizer for like 25 minutes. Not just quick mist from an inhaler.

rpenmanparker 

Seriously, I'm just foolin' around. It could be a better dispenser, even a better powder formulation. It isn't right of me to suggest that one brand isn't better than another just because the active ingredients are the same. If it does a better job for you, that's good enough reason to keep using it. Just seems funny...

topslop1

I bet that feels so damn good. Probably like 300% more effective than my little inhaler. Problem is half the time the inhaler I have is old, gunked up, or not working its 'best'.

They're pretty expensive regardless of whatever insurance you've got too so it's usually the case that I show up, ask for 10, get 1 full size and a handful of 2-3 small sample ones, then the small ones end up scattered and old and or working at 50% of their capacity, much like my lungs.

demoncyclist

I am on a daily controller medication (Singulair) as well as Albuterol. In my case it is ProAir HFA. I do tend to take a prophylactic dose before a ride, and will take additional doses as needed on longer rides, depending on air quality and temperature. I am on Zyrtec for seasonal allergies as well, and my breathing is definitely worse during certain times of the year- especially when the ragweed and other nasties are airborne in the early fall. The nebulizer that the OP is using gets the albuterol vapors (it is a liquid, not a powder)much deeper into the lungs, and the treatments are longer so it really gets into the tissue. As for cost, I get mine through Express Scripts, and the inhalers are $16 for a 90 day supply (3 inhalers). Costs vary, depending on who your insurer is.

rpenmanparker 

Yeah with decent insurance the inhalers are cheap. I don't know about nebulizers. That is too heavy duty for me.

bigdo13

Have you ridden a long one on it yet? I'm curious... seems like cycling just breeds asthmatics for some reason. Some a legit, others are just trying to score some of these inhaler PEDs.. lol

redlude97

They are still way more expensive than they used to be before the CFC ban. With good insurance I'm still paying $30-40/inhaler. Retail is around $70, whereas they used to be $10. Nebulizers are cost effective for those that need daily dosing instead of just preemptive for exercise induced.

redlude97

I've given curious fellow riders puffs and they don't seem to notice any difference

rpenmanparker 

Are you getting generics? I don't pay anything like that.

redlude97

Generic albuteral inhalers? From the US? There is no longer such thing as far as I know. What "brand" is on your inhaler?

bigdo13

LOL, The fact that guys willingly tried it in an attempt at gainz... is... hilarious.

rpenmanparker 

Maybe generic isn't the right term. I meant a brand of inhaler that is not associated with the earliest introduction of the drug, i.e. a post-patent entry to the market. I dunno if that has any real meaning. Forget I said anything about that. There apparently are cheaper and more expensive varieties. Anyway I use ProAir HFA at $35.99 for 3, 200-puff inhalers after insurance.

FBinNY 

Albuterol is a name that's only used in the USA (maybe not exclusively, so almost only). Elsewhere, the drug is called Salbutamol.

Before prescription drug (insurance) plans, I used to pay something close to $10.00 cash out of pocket for a refil, and a bit more for a complete inhaler. When drug plans became dominant this became an issue because the spot cash price was less than the insurance co-pay. For a while I'd get around the problem, by not bringing insurance, and peeling a few bills out of my money clip. Eventually, they solved the problem by raising the price, so the co-pay looked like a good deal.

Currently, I buy my Salbutamol over the counter in Cozumel paying like $30.00 (USD) for a pack of three complete inhalers.

DGlenday

I'm lucky, in that I don't have attacks while riding.

But after I stop ... It hits me like a train.

I'm trying to find some way of easing that problem...

FBinNY 

Try being more careful about winding down and cooling off. Or you might try bringing an inhaler and taking a dose of albuterol when you're 5 or 10 minutes from home.

Also, consider that your home may have allergens or other triggers at a level low enough for you to manage, but when you come in with the higher breathing rate from your ride, the combination brings you over the top. You might do an experiment by coming home, but staying outside until you've fully recovered, or at least close, and seeing if that improves things.

The key is to learn the patterns that cause attacks, then find workarounds. It takes patience and experimentation, but it's been my experience that it is usually manageable.

Hot Potato

My exercise asthma kicks in an hour or two AFTER a hard ride. I think the catecholamines and stress hormones of hard riding keep it at bay until after. So I took some beta agonists before riding and felt like crap while riding. Seems those "selective" drugs aren't too selective in me, and having a baseline tachycardia saps my energy. What I found worked was low dose inhaled steroid daily. Then use a beta agonist inhaler only after those rides that symptoms start to appear after stopping, which is way less frequent now. Gotta give inhaled steroids weeks to work?

Unfortunately, cold weather will cause symptoms during a ride, and just taking it easy seems to be the only effective treatment then, with or without a beta agonist inhaler. my move to Phoenix next month should fix that!

DGlenday

FB, many thanks for the reply. I have become careful about 'warming down' after rides, but the hacking still kicks in about 10 to 20 minutes after the ride. I'll try warming down a bit longer to see if it helps...

Your comments about allergens at home don't apply to my situation, as I usually drive to the start of a ride - and there are many different start locations, all over the county.

However a dose of albuterol 5 to 10 minutes from the end of the ride is a "blinding flash of the obvious", yet I hadn't thought of it. I always ride with an inhaler, and will definitely try that. Thanks for the idea.

The patterns that cause the attacks are pretty similar to many others in this thread: Cold, dry weather is worst, whereas I can often ride in warm humid weather and - as much as I hate the clammy heat - there's often no after effect at all. Maybe my answer is to move to Florida. (Now - I need my pulmonologist to convince my wife that I need to move for health reasons. )



I've tried the daily low dose inhaled steroid (Advair) - and I'm not convinced that it helps. I Googled "beta agonist inhaler" - and I think Albuterol is one of them..?

I think your move to Phoenix is the answer!

MikeyBoyAz

so.... I still don't understand why I get so dang shaky after I finish the vial with the atomizer... even now I can barely type. the [not] PED sure feels like a PED.

MikeyBoyAz

Must be like all the sets of NOT bibs that I have, which are actually bibs?

topslop1

Yesss. I've noticed shakyness and some kind of after effect - and this is using a regular inhaler, not the good stuff like what you've got there.

If you actually were to get on the bike you'd notice that your performance would suffer when pushed against a control group of yourself without having asthma and not needing to take any drug for your asthma.
^
obviously an imperfect science.

SO what I'm saying is - probably feels like you're getting a 'high' from it, but your performance will be poopie in comparison to 'not feeling high' or needing to take any.

redlude97

Yea albuterol has been off patent for years, and prior to 2009, albuterol inhalers could be had for ~$10 w/o insurance for generics. The pharma companies lobbied to ban all albuteral inhalers that used CFCs even though their environmental effect was minimal. All the new inhalers use the patented HFA dispersent so the retail cost is ~$60-70 now. You're lucky your insurance covers most of the cost, is it percentage based or copay based? Many insurances cover a lower percentage for "name brands" and since there are no generic inhalers people get shafted on inhaler costs. Some companies even limit the number of refills they cover/year at an unreasonably low number since its not technically supposed to be a daily use item.

Hot Potato

Yes, albuterol is a "beta adrenergic agonist" meaning it is epinephrine like, but different enough (beta 2 selective)that it will relax your airway like epinephrine without the same heart rate increase. Back in the day, epinephrine (primatene)was what you got, and your heart rate would skyrocket, and you would feel like you were having a heart/anxiety attack. I used to have halucinations when I was a child from that stuff. Which is why Mikey feels jittery - there may be less heart rate increase with beta 2 adrenergic agonists like albuterol, but for some (me included) there definitely still is quite a jump in heart rate and jitters.

The inhalers jumped in price becuase the propellants (cfc's I think?) were banned. Now the inhalers use proprietary, patented propellants so there arent any cheapie inhalers anymore.

rpenmanparker 

It's complicated fine print-based cost. No, seriously it's a percentage copay, and drugs are discounted by the pharmacy by contractual agreement. And for long term prescriptions the cost is the same for generic and specific. Our copay (employer sponsored Medicare Part D supplement) is higher for a specific drug if no generic exists. Actually as long as the specific is on the "preferred" formulary list, there is no difference for specifics even if there is a generic EXCEPT in the per prescription, out-of-pocket maximum. That is $100 for generics, $200 for preferred formulary specifics, and $300 for non-preferred formulary specifics. So for example, when I get Nexium my copay is $200 for 3 months (180 caps, 2X/day), but when I get Esomeprazole Mg, it is only $100. There is also a $2,500/year/patient ($5,000/year/family) out of pocket maximum for all drug purchases. It is a pretty sweet deal. For an 80/20 type Medicare supplement (not 100% coverage) that fills in the holes in Medicare A and B including this Part D plan, the premium is only $52/mo/participant.

rpenmanparker 

The steroids used in the daily low does inhalers and Albuterol are very similar. The difference seems to be that the former category is good for a continual effect while the Albuterol works better for short term requirements in individual situations. The mechanisms of action must be pretty similar though.

MoAlpha

Actually, if anyone's interested, the mechanisms are quite different. The smooth muscle in the walls of the small airways relaxes in response to beta2 adrenergic agonists, such as albuterol (which is not a steroid). This happens through fast, nerve-like, signaling. Steroids, by contrast, reduce the chronic inflammatory state in the airway walls, which makes them prone to spasm in asthma. This is a slow, long-lasting process.