The National Heart Lung and Blood Institute asthma management guidelines state that regularly scheduled, daily, ongoing use of short-acting bronchodilators such as albuterol is not recommended and can have deleterious respiratory effects.14 Long-term use of β2 agonists is associated with tachyphylaxis to the bronchodilating effect, reduced baseline FEV1 (possibly secondary to decreased airway caliber and rebound bronchoconstriction), increased bronchial hyper-responsiveness, and increased bronchial sensitivity to allergens.15–19 Such effects have been reported to occur at relatively low doses, within only a week of use.20,21