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QA16: What is the difference between albuterol (or ProAir) and inhaled steroids (like Flovent and Pulmicort)?

Albuterol and inhaled steroids are central to the management of asthma in children and adults.  Asthma is a chronic disease that often will have exacerbations in which patients encounters symptoms such as wheezing, coughing, or significant shortness of breath.  The best treatment for these acute symptoms is a rescue medication such as albuterol.  Albuterol works to relax the smooth muscles that surround the small airways in our lungs so that air can move more freely and as a result the patient has less wheezing, coughing, or no longer feels short of breath.  While albuterol will help alleviate the acute symptoms of an asthma attack, it is not a good medication to use on a chronic basis because it does not reverse the underlying inflammation that exists in the airways of an asthmatic.  Patients who have frequent asthma exacerbations, or decreased lung function (measured in our office using spirometry) need to be prescribed a controller (preventive) medication such as flovent.  Studies have shown that flovent (an inhaled corticosteroid) taken daily can improve lung function and reduce office visits for asthma as well as reduce albuterol use.  These medications have special roles in the management of asthma so it is important to talk with your provider in the office so that you know when to use each medication with your child. –Jason Reynolds, MD/PhD

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