Metabolic consequences of salbutamol poisoning reversed by propranolol.

Abstract

Metabolic consequences of salbutamol poisoning reversed by propranololAdministration of salbutamol, a beta2-adrenoreceptor agonist, is associated with several metabolic consequences including disturbances of carbohydrate, lipid, and potassium homeostasis.5Although the importance of these effects during therapeutic use of the drug is not clear, severe hypokalaemia has been reported after salbutamol poisoning.2As evidence suggests that the metabolic effects are due to beta-adrenoreceptor stimulation3 it seems logical to treat these results of salbutamol poisoning with a beta-adrenergic antagonist.We report a case in which salbutamol-induced hypokalaemia was managed successfully with propranolol. Case reportA previously healthy 17-year-old girl was admitted having taken an unspecified quantity of salbutamol 2 mg tablets (Ventolin) three hours previously.On admission she was agitated and tremulous and had a tachycardia of 156 beats/minute: an electrocardiogram showed the rhythm to be sinus.Blood pressure was 110/60 mm Hg.Gastric lavage was performed with no appreciable tablet return.Initial investigation showed a plasma