Is anyone else confused about all those inhalers?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629914/
"Fluticasone propionate is associated with an increased risk of pneumonia compared to budesonide in patients with COPD. In addition, the risk of pneumonia increased at higher ICS doses. Therefore, the types of ICSs and ICS doses need to be carefully considered in the treatment of COPD with ICS."

Even though this is a COPD study, having bronchiectasis we share symptoms with COPD.

Essentially, if one has asthma better to be on a budesonide inhaler vs. a fluticasone inhaler. Important to work with doctor to find the minimum effective dose.

Thanks. I didn't think so but it's always nice to have reassurance!

Albuterol alone is not a steroid.

I prefer nebulizing the albuterol also for the added "moisture". Maybe that's a psychological effect but if so, that's ok too. However, I never used it or needed it as a rescue inhaler sort of thing. I assume that is for someone that has asthma? And, if I understand it correctly, albuterol used for nebulizing is not a steroid right?

Albuterol is available in vial form for use in a nebulizer and also in a inhaler.
I prefer the nebulizer as it is mixed with saline and slowly administered over 10 minutes but is difficult if you are in the go. The small handheld inhaler is good for traveling or rescue type applications

I read over this post and the other comments and I must say it was enough to make my head spin! I am very thankful I do not have asthma to deal with along with MAC and Bronchiectasis. I empathize with those that have a more complicated picture to sort out. I did want to ask, after reading, I saw Albuterol (which I use twice daily followed by 7% saline as part of routine airway clearance) was listed as a rescue inhaler. However, it is not a steroid, just a bronchodilator? Just making certain as I don't want to have anything to do with steroids if not necessary! Some things are unavoidable, as with those with asthma must use something, but in my case I don't want to unnecessarily complicate the situation.

@harrynsc Well you are probably not wrong. Steroid inhalers do a lot of good, but steroids as a whole increase your risk. I only recently learned that - well within the past year after getting RSV. @scoop is correct about the albuterol and saline. It’s a catch 22 really. You need to get rid of all the yuckiness in your airways. There is a great article @rstel7272 shared a few months ago on the subject. Pulmonologists who know this fact about steroids ( all should) try to do a balancing act with it all, but we do need to breathe! @irene5

I was on Trelegy for two years and I'm convinced that the steroid in it dialed down
my immune system and that's why I got MAC.
Harry

That site is something I'll revisit. Since we suffer with "rare" disease it's difficult to know if something works for one if it will work for the other. The creator seems to have significant co-morbidities, further blurring things. While medicine today is far from perfect, it is evidence based, with many drugs taking years to research, develop, test and approve. How I wish I could throw away the inhalers, and only use albuterol and 7% saline! Have you tried doing that?

Scoop, are you a member of the facebook group "lung matters"? If not, you should join and read the guide lines, especially the chapter "𝗕𝗿𝗼𝗺𝗶𝗱𝗲𝘀 & 𝗦𝘁𝗲𝗿𝗼𝗶𝗱𝘀". This chapter saved my life.