A Study of Self Poisoning with Oral Salbutamol - Laboratory and Clinical Features

Abstract

1 The recent increase in asthma mortality coupledwith reports of fatal asthma associated with beta- 2-agonist therapy, has stimulated interest in the plasma concentrations of beta-2-agonists that produce systemic toxicity.

2 We prospectively studied 17 patients (9 male),mean age 23 years (range 2-72), who attendedthe emergency departments of hospitalsthroughout the United Kingdom having recently ingested an overdose of salbutamol.

3 Clinical, laboratory, ECG data, plasma and urine samples were obtained from each patient. Plasmawas assayed for salbutamol concentration using ahigh performance TLC-photodensitometric method.

4 The mean (± s.d.) salbutamol dose reported to have been ingested was 89(+83)mg and the mean plasma salbutamol concentration was 166 (range 18-449) ng ml potassium was 2.9 (s.d.±0.6) mM (n=16). None of^-1. The mean plasma the patients in this study developed serious cardiac dysrrhythmias.

5 There were significant correlations between the plasma salbutamol concentration and plasma potassium concentration (r=-0.85; P<0.00005) and between plasma salbutamol concentration and pulse rate (r=0,66; P<0.005).

6 We conclude that in these patients, without respiratory decompensation, suprapharmacological plasma concentrations ofsalbutamol were tolerated without serious cardiac arrhythmias or any fatalities.