Q. Please tell me the difference in oral albuterol and albuterol that is in a breathing treatment machine... when it comes to Bronchiolitis. In other words do they both accomplish the same things? My daughter is diagnosed with Bronchiolitis. We just switched doctors. In the past when one of my kids had this the nebulizer worked great, and the oral did nothing for them. The doctor we saw today gave her a breathing treatment in his office and then prescribed me an oral albuterol. When I asked him if he could switch it to the albuterol for the breathing treatments he said she did not need the treatment albuterol. I asked the difference and also questioned why he would give her one in his office if she didn't need one. He said he could do nothing for me and walked out. I am so confused. Please help me somewhat understand this. Tandy, Douglasville, Georgia
A. In general, an inhaled form of albuterol works better, works faster, and has fewer side effects than the oral form, like from albuterol syrup.
Since you need a nebulizer machine to give breathing treatments with albuterol, it is not always the most convenient or least expensive option for children with bronchiolitis and mild symptoms. However, it sounds like you already have a nebulizer, so the nebulized form of albuterol probably would have been a better option for you.
You can also give inhaled albuterol to young children using a metered dose inhaler with a spacer and mask, like the Aerochamber Plus valved holding chamber. Again, because of the extra cost of the spacer and mask, this isn't an inexpensive option either.
So the doctor likely prescribed oral albuterol because he didn't take the time to learn that you already had a nebulizer. And he may not have thought that your child was sick enough to require a nebulizer.
Why does oral albuterol have more side effects? It makes sense when you consider that to work in a child's lungs, oral albuterol has to go through the stomach and then get absorbed into the bloodstream and then make its way to the lungs. Along the way, it has a lot of chances to affect other parts of your body. On the other hand, an inhaled form of albuterol goes straight to the lungs. While they can still cause side effects, in general they are not as common or as strong as with oral albuterol. And the inhaled forms of albuterol should work faster too.
Albuterol as a Cough Medicine
It is also important to keep in mind that albuterol really isn't a cough medicine. It may help if a child's cough is being caused by wheezing, like from asthma or bronchiolitis, but not if you have a simple cold.
Albuterol for Bronchiolitis
The use of albuterol for bronchiolitis is also controversial. Many studies have shown no benefit to using albuterol, either the oral form or inhaled albuterol, to treat children with RSV and bronchiolitis. Many doctors still believe that albuterol works for these children with bronchiolitis though, and they will try a breathing treatment and then prescribe albuterol if the child seems to improve.
Your Pediatrician should be able to answer your questions for you, either during the visit or with a call later on if they are too busy. If your doctor really 'answered' your questions by saying 'he could do nothing' and then walked out, you should likely look for another Pediatrician...
Related Resources about Bronchiolitis and RSV