Albuterol may have serious cardiovascular effects in hypoxic asthmatics

המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-17 9:30:11 EDT (Reuters Health)

LONDON (Reuters Health) – The effect of inhaled beta-2 agonists such as salbutamol (albuterol) on hypoxic asthmatics might help explain sudden death following asthma treatment, according to Dutch researchers.

Reporting in the July issue of Thorax, Dr. J. Burggraaf, of the Centre for Human Drug Research, Leiden, and colleagues note that they investigated the systemic vascular effects of salbutamol and hypoxia by using forearm blood flow (FBF) as a measure of peripheral vasodilatation.

The researchers studied eight men with mild asthma who, for 60-minute periods, using a face mask, breathed ambient air or a variable nitrogen/oxygen mixture that was adjusted to provide 80% peripheral oxygen saturation. At 30 minutes, subjects inhaled salbutamol 800 µg or placebo, and FBF was evaluated at 30 and 60 minutes after baseline.

No significant differences were seen in blood pressure or potassium levels. However, FBF at 60 minutes was 13% greater following hypoxia and placebo than it was following normoxia and placebo. It was 21% greater for normoxia and salbutamol than for normoxia and placebo, and 32% greater for hypoxia and salbutamol than for hypoxia and placebo.

Compared with normoxia and placebo, say the investigators, "the inhalation of salbutamol during hypoxia resulted in a significant increase of FBF of 45%."

The researchers conclude that "asthmatic patients in respiratory distress should be given beta-2-agonists and oxygen concomitantly whenever possible."

In an accompanying editorial, Dr. Brian J. Lipworth, of the University of Dundee, UK, points out that when oxygen is not available "the benefits of high-dose beta-2-agonist treatment will outweigh any theoretical risks of a potential interaction with hypoxaemia." Nevertheless, he agrees that "it may be prudent for primary care doctors to co-administer oxygen when delivering high doses of beta-2-agonist."

Thorax 2001;56:506-507,567-569.

-London Newsroom +44 20 7542 7986

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