Hx: asthma, pts = sm airway, asmanex x1 qhs. new prescription mn txs unit dose albuterol q4 prn. used 13 of 25 doses in 40 days. is this reasonable frequency?

Check with your doc: Albuterol use means that your asthma is uncontrolled. It is rescue medication. You appear to need more anti -inflammatory medication and it seems that your asmanex is underdosed. Most likely you will have to increase the asmanex, possibly 2 inhalations twice daily to stop the need for albuterol. Symptoms are the tip of the ice berg. Check with your lung doc.

Uncontrolled: You should not be using albuterol more than 1-2 times a week if your asthma is controlled. Obviously this treatment regimen is not controlling your asthma. You need to call your doctor and tell them to adjust your treatment. Small airway disease responds better to other ICS such as alvesco, (ciclesonide) Qvar and maybe pulmicort, all of this needs to be discussed with your doctor.

No: You should not be using a rescue inhaler as frequently as you are describing. It would appear that you are constantly being exposed to your "trigger(s)" and your controller is not working effectively. Have your physician reevaluate your controller treatment.