No significant differences in FEV1 have been demonstrated between metered-dose inhalers (with or without a spacer) and nebulizers for SABAs in clinical trials nebulizers may be more convenient for patients who are more acutely ill.ġ5 to 17 years: 32 mg/day PO for syrup and tablets FDA-approved labeling for inhaler recommends not exceeding 12 puffs/day FDA-approved labeling for nebulizer solution for oral inhalation recommends not exceeding 4 doses/day or 10 mg/day (0.083% or 0.5% nebulizer solution), 2.5 mg/day (0.63 mg/3 mL nebulizer solution), and 5 mg/day (1.25 mg/3 mL nebulizer solution). Short-acting beta-2 agonists (SABAs) are preferred therapy for acute COPD exacerbation, used with or without a short-acting anticholinergic. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, inhaled albuterol may be used as first-line therapy in Group A and may also be used in Groups B, C, and D for additional symptom control. Optimal dosing for acute COPD exacerbation is not established adjust dose according to clinical symptoms or the development of adverse effects higher or more frequent dosing may be needed. In some patients, 90 mcg (1 actuation) every 4 hours may be sufficient. 180 mcg (2 actuations of 90 mcg/actuation) inhaled by mouth every 4 to 6 hours as needed for symptoms.
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