Side Effects of albuterol: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major research findings

Albuterol, a common medication for asthma, has been associated with various side effects. 7 reported a case of severe lactic acidosis and persistent diastolic hypotension in a child after receiving standard dose of nebulized albuterol. 13 found that lower doses of continuous albuterol were associated with less toxicity and less need for adjunctive therapies in critically ill children with status asthmaticus. 19 identified diastolic hypotension as a risk factor for beta-agonist-associated myocardial injury in children with asthma. 12 explored the development of bioadhesive vaginal tablets of salbutamol for preterm labor, aiming to reduce side effects from conventional oral and injection administrations.

Reasons for side effects

Albuterol, as a β2-receptor agonist, works by relaxing bronchial smooth muscle, opening the airway, and improving asthma symptoms. However, β2 receptors are also present in the heart and blood vessels, and albuterol can also act on these tissues, which may lead to side effects such as increased heart rate, decreased blood pressure, and hypokalemia. 9 suggests that enteral albuterol may be an effective treatment for bradycardia and hypotension in patients with acute cervical spinal cord injury. 16 reports on the development of a method to deliver albuterol directly to uterine myocytes, which is expected to reduce side effects.

Common side effects

Increased heart rate

Albuterol can affect the heart and increase heart rate. 8 observed increased heart rate in anesthetized horses after inhaling albuterol.

Decreased blood pressure

Albuterol can affect blood vessels and decrease blood pressure. 7 reported a case of decreased diastolic blood pressure in a child after inhaling albuterol. 19 cites diastolic hypotension as a risk factor for beta-agonist-associated myocardial injury in children with asthma.

Hypokalemia

Albuterol can reduce potassium levels in the body. 3 showed that intravenous or intramuscular albuterol decreased serum potassium levels.

Lactic acidosis

Albuterol can cause lactic acidosis. 7 reported a case of severe lactic acidosis in a child after inhaling albuterol.

Tremor

Albuterol can cause tremor. 1 observed a dose-dependent increase in tremor amplitude after inhaling albuterol in patients with chronic obstructive pulmonary disease. 3 also reported tremor after albuterol administration.

Tachycardia

Albuterol can increase heart rate and therefore may cause tachycardia. 11 investigated changes in heart rate after inhaling albuterol, suggesting that the use of a spacer reduces the increase in heart rate.

Urinary retention

Albuterol may cause urinary retention. 21 reported a case of acute urinary retention in a child after receiving oral albuterol.

Myoclonus

Albuterol may cause myoclonus. 15 reported a case in which myoclonus occurred after albuterol administration and the symptoms improved after stopping albuterol.

Measures to prevent side effects

Increased heart rate

If you are concerned about an increased heart rate, consult your doctor. If necessary, drug therapy to reduce heart rate may be performed. 11 suggests that the use of a spacer can reduce the increase in heart rate.

Decreased blood pressure

If your blood pressure is too low, consult your doctor. Drug therapy to increase blood pressure may be performed if necessary.

Hypokalemia

If you suspect symptoms of hypokalemia, consult your doctor. Potassium supplementation therapy will be performed if necessary.

Lactic acidosis

If you suspect symptoms of lactic acidosis, consult your doctor immediately. Hospitalization may be necessary in severe cases.

Tremor

If you are concerned about tremor, consult your doctor. Drug therapy to suppress tremor may be performed if necessary. 1 suggests that reducing the dose of albuterol may reduce tremor.

Tachycardia

If you are concerned about tachycardia, consult your doctor. Drug therapy to reduce heart rate may be performed if necessary. 11 suggests that the use of a spacer can reduce tachycardia.

Urinary retention

If you experience urinary retention, consult your doctor immediately.

Myoclonus

If you experience myoclonus, consult your doctor immediately. You may need to stop taking albuterol.

Comparison between studies

Common points of studies

Many studies have shown that albuterol can cause side effects such as increased heart rate, decreased blood pressure, and hypokalemia.

Differences in studies

The incidence and severity of side effects vary depending on the route of administration, dosage, and target patient of albuterol. 3 compared intravenous, intramuscular, and subcutaneous administration of albuterol in a study, and differences in serum potassium levels were observed depending on the route of administration. 13 showed that lower doses of continuous albuterol were associated with less toxicity and less need for adjunctive therapies in a study on children with severe asthma. 12 describes the development of bioadhesive vaginal tablets of salbutamol for preterm labor. This vaginal delivery aims to reduce side effects from conventional oral and injection administrations.

Points to note for application to real life

Albuterol is an effective bronchodilator, but it is important to consider the risk of side effects. When taking albuterol, follow your doctor's instructions and take the correct dosage. Also, consult your doctor immediately if you feel any abnormalities while taking it. In particular, it is important to consult your doctor before taking albuterol if you have any underlying medical conditions such as heart disease or high blood pressure. 6 points out that the combined use of albuterol and vasoactive agents in the treatment of severe lung injury needs to be carefully considered due to the risk of interactions. 14 reported that inhaled albuterol was effective in controlling blood glucose fluctuations in the treatment of non-oliguric hyperkalemia in preterm infants compared to conventional glucose-insulin therapy.

Limitations of current research

Research on the side effects of albuterol is still not sufficient. In particular, further research is needed on the side effects of albuterol in specific populations such as children and the elderly. 18 investigated the incidence and risk factors for diastolic hypotension during continuous albuterol administration in children with asthma.

Future research directions

It is necessary to develop new treatment methods and administration methods to reduce the side effects of albuterol. 22 is conducting a clinical trial to investigate the efficacy of intravenous albuterol in the treatment of severe acute respiratory distress syndrome (ARDS). 16 reports on the development of a method to deliver albuterol directly to uterine myocytes, which is expected to reduce side effects. 12 describes the development of bioadhesive vaginal tablets of salbutamol for preterm labor. This vaginal delivery aims to reduce side effects from conventional oral and injection administrations.

Conclusion

Albuterol is an effective bronchodilator, but it has the risk of side effects such as increased heart rate, decreased blood pressure, and hypokalemia. When taking albuterol, follow your doctor's instructions and take the correct dosage. Also, consult your doctor immediately if you feel any abnormalities while taking it.

Literature analysis of 22 papers
Positive Content
14
Neutral Content
1
Negative Content
7
Article Type
4
1
1
1
21
1.

High-dose inhaled albuterol in severe chronic airflow limitation.

Author: VathenenA S, BrittonJ R, EbdenP, CooksonJ B, WharradH J, TattersfieldA E

Bronchodilatation
Improved walk distance
Decreased oxygen saturation
Ectopic beats
Increased heart rate
Tremor

Higher doses of inhaled albuterol were associated with greater bronchodilation but also more side effects in 30 patients with chronic bronchitis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Prior treatment with diuretic augments the hypokalemic and electrocardiographic effects of inhaled albuterol.

Author: LipworthB J, McDevittD G, StruthersA D

Improves bronchodilation
Cardiac arrhythmias
Hypokalemia
Hypomagnesemia

High doses of inhaled albuterol, a bronchodilator, can cause hypokalemia and hypomagnesemia, which may be exacerbated by diuretic therapy, potentially leading to cardiac arrhythmias.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Efficacy of parenteral albuterol in the treatment of asthma. Comparison of its metabolic side effects with subcutaneous epinephrine.

Author: RohrA S, SpectorS L, RachelefskyG S, KatzR M, SiegelS C

Improved lung function
Low potassium

Albuterol sulfate, a bronchodilator, was found to have similar efficacy regardless of the parenteral route of administration. However, all routes of administration resulted in a clinically significant decrease in serum potassium levels, comparable to the decrease observed with epinephrine. The decrease in potassium may have important clinical implications.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Giant lung cavity due to three different pathogens in a patient receiving inhaled salmeterol plus fluticasone propionate for asthma.

Author: Güner ZirihNeşe Merve, Yilmaz KaraBilge, ÖzyurtSongül, OkçuOğuzhan, İlgarTuğba, ŞahiNÜnal

Giant cavity
Opportunistic infections

A patient with asthma who developed a giant lung cavity while using inhaled salmeterol plus fluticasone propionate highlights the potential for opportunistic infections, including tuberculosis, in patients using inhaled corticosteroids.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

The Beta2-adrenergic agonist salbutamol synergizes with paclitaxel on cell proliferation and tumor growth in triple negative breast cancer models.

Author: JabloñskiMartina, RodríguezMaría Sol, RiveroEzequiel Mariano, BruqueCarlos David, VanzulliSilvia, BruzzoneAriana, Pérez PiñeroCecilia, LüthyIsabel Alicia

Triple-negative breast cancer, a particularly aggressive subtype, lacks specific targeted therapies and is treated with chemotherapy, which can have significant side effects. This study aims to investigate if the dose of chemotherapeutic drugs could be reduced by co-administering it with the β2-agonist salbutamol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Severe lactic acidosis and persistent diastolic hypotension following standard dose of intermittent nebulized salbutamol in a child: a case report.

Author: ColomboMarco, PlebaniAnna, BoscoAnnalisa, AgostiMassimo

Asthma treatment
Diastolic hypotension
Lactic acidosis

This case report describes a rare instance of lactic acidosis and diastolic hypotension following intermittent salbutamol nebulization in a child at a standard therapeutic dose, highlighting the need for awareness of these potential side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Effectiveness of Spacer Devices on Preventing Undesirable Cardiovascular Effects of Inhaled Salbutamol.

Author: GomesJuliana Teixeira, GregorioPaulo Henrique Peitl, SantosEllen Samara, RibeiroBruna Patricia, GregórioMarcelo Gervilla

Asthma treatment

This study examined the effects of using a spacer device (VHC) during spirometry tests with salbutamol, a common drug used to treat asthma. The study found that using a VHC significantly reduced the cardiovascular side effects of salbutamol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Nebulized salbutamol diminish the blood glucose fluctuation in the treatment of non-oliguric hyperkalemia of premature infants.

Author: SawHean-Pat, ChiuCheng-Di, ChiuYou-Pen, JiHui-Ru, ChenJia-Yuh

Hyperkalemia treatment

Salbutamol nebulization was as effective as glucose-insulin infusion for treating non-oliguric hyperkalemia in premature infants, without affecting blood sugar stability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Myoclonus induced by salbutamol: A case report

Author: Montoya-GiraldoMaría Alejandra, MontoyaDayana Vanessa, AtehortúaDavid Alexander, BuendíaJefferson Antonio, ZuluagaAndrés Felipe

Myoclonus

Salbutamol is a common medication for treating lung diseases, but it can cause side effects like tachycardia and tremor. This case report describes a patient who experienced myoclonus, involuntary muscle contractions, after taking salbutamol. The myoclonus resolved only after discontinuing the drug, suggesting that salbutamol may be a less common cause of myoclonus.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Drug delivery to the human and mouse uterus using immunoliposomes targeted to the oxytocin receptor.

Author: PaulJonathan W, HuaSusan, IlicicMarina, TolosaJorge M, ButlerTrent, RobertsonSarah, SmithRoger

Improved therapeutic efficacy
Minimized side effects
Targeted drug delivery

Treating obstetric complications like preterm labor and postpartum hemorrhage is challenging due to the systemic toxicity of therapeutic agents. This study explores the use of ligand-targeted liposomes as a novel strategy for targeted drug delivery to uterine myocytes, aiming to improve efficacy and minimize side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Diastolic hypotension in pediatric patients with asthma receiving continuous albuterol.

Author: WisecupSarah, EadesShannan, HashmiSyed Shahrukh, SamuelsCheryl, MosqueraRicardo Alberto

Cardiac side effects
Hypotension

This study aimed to determine prevalence and potential risk factors for hypotension development during continuous albuterol administration in pediatric patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Diastolic hypotension is an unrecognized risk factor for β-agonist-associated myocardial injury in children with asthma.

Author: SarnaikSyana M, SaladinoRichard A, ManoleMioara, PitettiRaymond A, AroraGaurav, KuchBradley A, OrrRichard A, FelmetKathryn A

Myocardial injury

This study hypothesized that diastolic hypotension is associated with β-agonist use and that diastolic hypotension and tachycardia are associated with biochemical evidence of myocardial injury in children with asthma.

Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Addition of intravenous beta(2)-agonists to inhaled beta(2)-agonists for acute asthma.

Author: TraversAndrew H, MilanStephen J, JonesArthur P, CamargoCarlos A, RoweBrian H

Improved pulmonary index
Shorter recovery time
Tremor

Inhaled corticosteroids (ICS) were shown to reduce hospital admissions in patients with acute asthma, especially when combined with systemic corticosteroids.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Urine retention in a child treated with oral salbutamol.

Author: D'AuriaEnza, MandelliMarzia, Di DioFrancesco, RivaEnrica

Urinary retention

This case report describes a 3-year-old boy who experienced two episodes of acute urinary retention after oral salbutamol therapy. While other systemic salbutamol side effects are known in children, this is the first reported case of acute urinary retention as an adverse drug reaction to oral salbutamol.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Beta Agonist Lung Injury TrIal-2 (BALTI-2) trial protocol: a randomised, double-blind, placebo-controlled of intravenous infusion of salbutamol in the acute respiratory distress syndrome.

Author: PerkinsGavin D, GatesSimon, LambSarah E, McCabeChris, YoungDuncan, GaoFang

Improved survival in ARDS

This article describes the Beta Agonist Lung Injury TrIal (BALTI-2), a multicentre, pragmatic, randomised, double-blind, placebo-controlled clinical trial which aims to determine if sustained treatment with intravenous (IV) salbutamol will improve survival in acute respiratory distress syndrome (ARDS).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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