When a patient in the hospital is having trouble breathing, whether it's from asthma, chronic bronchitis, emphysema, or something else, a respiratory therapist will try to relax their airways with medication. The go-to medicine in a situation like this is what is called a short-acting bronchodilator, like Albuterol. It provides quick relief of symptoms like airway spasms or wheezing while respiratory therapists work on longer-term solutions. But short-acting bronchodilators might be overused, according to the director of research in the Department of Respiratory Care in the School of Health Professions at The University of Texas at San Antonio, Dr. Ruben Restrepo.
"I think the tendency is we get very comfortable, and then sometimes we don't measure the actual need for that," Restrepo said. "Unfortunately, in respiratory therapy, we don't have a lot of evidence-based medicine to evaluate this."
So, Restrepo has been evaluating it. He is also a respiratory care professor at UT San Antonio, and he's enlisted his students to help him measure patient response to short-acting bronchodilators. They're doing that by evaluating a patient's breathing before they're treated with a medication like Albuterol, and then after treatment. They use a tool called a peak flow meter to measure a patient's ability to expel air from their lungs quickly.
"I should be able to get at least 15% or greater improvement to determine that I have a good response to the bronchodilator," Restrepo said. When patients do not improve by at least 15%, it's an indication that a short-acting bronchodilator may not be the most appropriate medication for this situation.
A 2025 pilot study supports the idea that Albuterol may be overused. "What we found with the students last year is that, for the most part, there's not really a clear indication for the bronchodilator to be prescribed," Restrepo said.
In his current study, which is being funded with a $50,000 grant from the American Association for Respiratory Care, Restrepo's team has already evaluated dozens of patients, and plans to include 150 by the end of the year. The results could guide respiratory therapists to more evidence-based treatments in the future.
"I don't pretend that a study on 150 subjects is going to change the world, but I think it's going to be a good start," he said. "And that's what I'm hoping, that it contributes to rationalized treatments in every single area of the hospital where patients receive albuterol."
Science & Medicine is a collaboration between TPR and The University of Texas Health Science Center at San Antonio, about how scientific discovery in San Antonio advances the way medicine is practiced everywhere.
