Can you od on albuterol
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Can You Overdose on Albuterol?
Albuterol, a commonly used bronchodilator for asthma and other respiratory conditions, can indeed be overdosed on, leading to a range of symptoms and complications. This article synthesizes findings from multiple research studies to provide a comprehensive understanding of albuterol overdose, its symptoms, and treatment options.
Symptoms of Albuterol Overdose
Cardiovascular Effects: Tachycardia and Hypotension
One of the most frequently reported symptoms of albuterol overdose is tachycardia, a condition characterized by an abnormally fast heart rate. This symptom was observed in a significant number of pediatric cases, with 57% of children experiencing it after ingesting albuterol4. Hypotension, or low blood pressure, is another cardiovascular effect that can occur, although it is less commonly reported.
Neuromuscular Effects: Tremor and Agitation
Tremor and agitation are also common symptoms of albuterol overdose. These neuromuscular effects were noted in multiple cases, including a 22-month-old child who exhibited marked agitation and tremulousness after ingesting a large dose of albuterol3. Similarly, two asthmatic adolescents who overdosed on albuterol were described as being tremulous and agitated2.
Metabolic Effects: Hypokalemia and Hyperglycemia
Albuterol overdose can lead to significant metabolic disturbances, including hypokalemia (low potassium levels) and hyperglycemia (high blood sugar levels). Hypokalemia was observed in several cases, with one study noting it in 26% of pediatric patients4. Hyperglycemia was also a common finding, with one child exhibiting a blood sugar level of over 320 mg/dL3.
Rare Complications: Hypoglycemia
While hyperglycemia is more commonly associated with albuterol overdose, hypoglycemia (low blood sugar) can also occur, albeit rarely. A case study described a 3-year-old boy who developed hypoglycemia four hours after ingesting a high dose of albuterol1. This suggests that hypoglycemia could be a late complication of acute albuterol overdose.
Treatment and Management
Initial Interventions: Activated Charcoal and Hydration
Initial treatment for albuterol overdose often includes the administration of activated charcoal to limit drug absorption and intravenous hydration to support cardiovascular function. These interventions were successfully used in the case of the 3-year-old boy who ingested a high dose of albuterol1.
Specific Treatments: Propranolol
In cases where symptoms are severe, specific treatments such as intravenous propranolol, a beta-blocker, can be effective. Two asthmatic adolescents who overdosed on albuterol were successfully treated with IV propranolol without developing bronchospasm2.
Observation and Monitoring
Given the potential for delayed complications such as hypoglycemia, extended observation periods may be necessary. In the case of the 3-year-old boy, hypoglycemia was identified four hours after admission, highlighting the need for prolonged monitoring1.
Conclusion
Albuterol overdose can lead to a variety of symptoms, including tachycardia, tremor, hypokalemia, and hyperglycemia. While most cases result in benign outcomes and do not require specific treatment, severe cases may necessitate interventions such as propranolol and extended observation periods. Understanding these potential complications and their management is crucial for healthcare providers to ensure patient safety.
Sources and full results
Most relevant research papers on this topic
Hypoglycemia After Albuterol Overdose in a Pediatric Patient
Hypoglycemia may be a late complication of acute albuterol overdose in children, requiring extended observation and glucose replacement.
Case ReportPropranolol treatment of albuterol poisoning in two asthmatic patients.
Propranolol effectively treats albuterol overdoses in asthmatic adolescents, preventing bronchospasm and demonstrating its effectiveness in treating tremulous, tachycardic, and hypokalemic conditions.
Case ReportAlbuterol overdose: A case report and differential diagnosis
Albuterol overdoses in children can cause agitation, tremulousness, hyperglycemia, ketonuria, and hypokalemia, but generally result in benign outcomes when compared to diabetics or pregnant patients.
Case ReportUnintentional albuterol ingestion in children
Unintentional albuterol ingestion in children causes short-lived, benign effects, with a threshold dose of 1 mg/kg for three or more signs of toxicity.
Observational StudyA high dose of albuterol does not overcome bronchoprotective subsensitivity in asthmatic subjects receiving regular salmeterol or formoterol.
A high dose of albuterol does not overcome bronchoprotective subsensitivity in stable asthmatic subjects receiving regular salmeterol or formoterol treatment.
RCT
Rigorous JournalEffect of different albuterol dosing regimens in the treatment of acute exacerbation of chronic obstructive pulmonary disease.
Frequent dosing of albuterol may have an advantage in patients with initially severe bronchospasm, but may also cause more frequent side effects.
RCTHigh-versus low-dose, frequently administered, nebulized albuterol in children with severe, acute asthma.
High-dose, frequently administered nebulized albuterol is safe and effective in treating severe, acute asthma in children, with greater improvement in symptoms and lower hospitalization rates.
RCT
Highly CitedAlbuterol-Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma.
A fixed-dose combination of 180 g of albuterol and 160 g of budesonide significantly reduces the risk of severe asthma exacerbation compared to albuterol alone in patients with uncontrolled moderate-to-severe asthma.
RCT
Large Human TrialRigorous JournalNebulized albuterol in acute childhood asthma: comparison of two doses.
Hourly high-dose albuterol therapy is recommended for pediatric patients with moderate to severe acute asthma, especially those who relapse between doses.
RCTContinuous versus intermittent albuterol nebulization in the treatment of acute asthma.
Both intermittent and continuous albuterol nebulization are safe for treating acute asthma, with continuous nebulization showing a higher rate of percent predicted FEV1 increase.
RCTHighly Cited