At our SCM meet this past weekend we had an out-of-state visitor swimming. She was a very serious swimmer, arrived a week early to acclimate, came with a bit of an entourage, and did some pretty amazing times (45-49). We also saw her taking frequent hits from a very large inhaler always just before her races as she was warming up and behind the blocks. Any thoughts?.
In addition, everyone should use a spacer when taking albuterol -- it increases the pulmonary deposition of the albuterol by a factor of three or more. You have more side-effects without it as well.
I've been taking Albuterol for about 25 years, and rarely (maybe 5-10 times) have used a spacer. I didn't even know about them until about 10 years ago, and it just doesn't seem as effective for me when I do.
But I can't even remember the last time I used mine as a rescue inhaler. I've been taking Asmanax for 5-8 years 2x a day. I'll use Albuterol to clear my lungs and the Asmanax seems much more effective.
All that said, yes I do feel like it helps my performance, especially in cooler water like an open-water swim, and also for longer pool swims (the 800/1500). I haven't really noticed any difference in shorter events. I definitely feel a difference in running too, especially in cooler air and/or when pollution is high.
A few years ago, chlorofluorocarbon-propellant albuterol inhalers were replaced by HFA-propellant inhalers (it was claimed this was for environmetal reasons, but reality is that there is patent protection on HFA Inhalers so no generics exist.).
The new inhalers, in a word, suck. If I am having an airway obstruction I take 10 puffs if not more (which means, in addition to being more expensive, I have to buy them more often). So from personal experience, I wouldn't judge anyone who "over-medicates" on the new inhaler. They just dont work as well.
I will add that all inhalers are the same size. It might have appeared larger because she was using a spacer (which makes the delivery of the medicine more effective).
The pulmonary deposition of most HFA inhalers is superior to their CFC predecessors. Most studies show improved efficacy with the newer inhalers. With less deposition in the mouth, some people feel that they are getting less but the reality appears to be the opposite.
The switch from CFC was almost 10 years in the making and was motivated by the environmental concerns. Unfortunately, only one of the manufacturers of generic albuterol was prepared to switch to HFA. When they realize that they were the only one, they decided to price themselves like a brand name and drug. This looks as if it will change in the future.
This is just not true. The pulmonary deposition is as good or better with HFA than compared to CFCs (depending on which med you use) and all physiology efficacy studies have shown them to be the same. In addition, every respiratory specialist that I know --and I know a lot -- feel that they are equivalent. I can't imagine what you mean by "universally."
That's interesting, I will have to look into that. I know numerous people- patients, pharmacists, physicians, teachers, who find the new CFC's to be not as effective. Physiological efficacy studies should show them to be the same, otherwise they probably wouldn't be on the market.
I have had asthma since I was a kid. Swimming eliminated most of it.
I still have an occasional attack and sometimes have exercise induced asthma. I still keep a rescue inhaler around just in case.
Maybe I have not had access to the good stuff – or maybe using an inhaler only when you need it eliminates the benefit - but I have never felt any kind of benefit from using an inhaler.
I have had asthma since i was a kid and thought it was exercize induced until i went for allergy testing 10 years ago ( damn cat ), and they tested my breathing and said i had the lung power of a 70 yr old ( i was 40 at the time ). I think i just got used to being short of breath when i wasnt exercizing and took ventolin before a workout.
I now take advair twice a day and nothing else.
I thought asthma targeted inhalers provide no advantage to athletic performance, just lessens performance harming effects caused by a medical condition
These are also very good points. The new HFA inhalers are universally believed to be not as effective. .
This is just not true. The pulmonary deposition is as good or better with HFA than compared to CFCs (depending on which med you use) and all physiology efficacy studies have shown them to be the same. In addition, every respiratory specialist that I know --and I know a lot -- feel that they are equivalent. I can't imagine what you mean by "universally."
In addition, everyone should use a spacer when taking albuterol -- it increases the pulmonary deposition of the albuterol by a factor of three or more. You have more side-effects without it as well.
We should remember though, you always have to remember with clinical trials. Especially if the drug company chooses who gets to be in it. Results can be skewed.
For example, antidepressant studies never used very depressed people for fear of suicide. Therefore, the people they are using are people who may not really be depressed and people who may become healthy again with a short amount of time. Similarly, if they are using "healthy" patients, patients without severe conditions, the efficacy of the drug is in question. The inhalers are fast acting. If a pt with severe respiratory problems was to have a severe problem that the new inhaler does not adequately treat, that puts the patient at risk. Therefore, unhealthy test subjects aren't used.
At our SCM meet this past weekend we had an out-of-state visitor swimming. She was a very serious swimmer, arrived a week early to acclimate, came with a bit of an entourage, and did some pretty amazing times (45-49). We also saw her taking frequent hits from a very large inhaler always just before her races as she was warming up and behind the blocks. Any thoughts?.
Maybe she had friends/relatives to visit in the area, thus the early arrival. Perhaps socializing with her local contacts continued at the meet, giving the appearance of an entourage.
I too would assume this woman is taking albuterol or some form of it, as it is the most commonly prescribed inhaler. So is albuterol (or some other bronchodilator) performance enhancing?
I honestly don't think it would make that big of a difference if you did not have a breathing problem to start off with.
Just because you're taking it doesn't mean you're cheating. For all we know, she could have a legitimate breathing problem. I don't think they could ever outlaw taking legal medicine for legitimate health concerns or deny the swimmer over usage of the medicine. It is well known that swimmers have an increased rate of asthma due to irruption caused by the chlorine in the air.
Usually inhalers are instructed to be taken as needed. Additionally, the effects of Albuterol are very short lived, I would say at best 15 minutes. I also remember reading something that said whether you take a relatively normal breath or HUGE breath doesn't significantly improve the amount of oxygen you receive and the duration you can hold your breath (this was in reference to shallow water blackout).
Psychologically, I might see how having the feeling of easier breathing might make you more confident. I don't know. I don't think you can make accusations if you don't know her medical history and statistics (peak flow, etc), but if she is a healthy individual, I don't think albuterol would be a real performance enhancer.
- 3rd Year Pharm.D student
A few years ago, chlorofluorocarbon-propellant albuterol inhalers were replaced by HFA-propellant inhalers (it was claimed this was for environmetal reasons, but reality is that there is patent protection on HFA Inhalers so no generics exist.).
....
I will add that all inhalers are the same size. It might have appeared larger because she was using a spacer (which makes the delivery of the medicine more effective).
These are also very good points. The new HFA inhalers are universally believed to be not as effective. Many doctors also prescribe spacers to increase the efficacy of the drug delivery. Furthermore, the thread starter said she was taking "big hits" or something to that effect. That just means she was actually using the medicine correctly. Most people do not breath in hard enough to get the medicine where it's supposed to go.
Additionally, repeated doses can also be caused by a dirty inhaler. Most people don't know that your inhaler should be cleaned after every use. Failure to clean the device decreases its output.
