What is the usual albuterol dosing for an MDI with spacer?

• A. 1-2 puffs (90 mcg per puff) with spacer; may repeat up to 3 total doses
• B. 3-4 puffs
• C. 1 puff
• D. 2 puffs every 15 minutes

Answer: (A)

Dosing by metered-dose inhaler with a spacer uses small, repeatable inhalations rather than a large single dose. Each puff delivers about 90 micrograms of albuterol, and the usual rescue approach is 1–2 puffs per dose with the spacer, then repeats up to a total of three doses as needed, reassessing after each dose. The spacer improves lung delivery by reducing coordination requirements and minimizing oropharyngeal deposition, making this method effective even for patients who aren’t perfect at timing their inhalation. If there’s little or no improvement after three doses, follow protocol for further treatment or transport. The other options either exceed the typical initial dose, provide too little for relief, or imply a dosing pattern that doesn’t reflect the standard total-dose cap.