title: High serum albuterol levels and tachycardia in adult asthmatics treated with high-dose continuously aerosolized albuterol.
abstract: To study the feasibility of using high-dose continuously aerosolized albuterol aerosol in adults, seven adult asthmatic patients were treated eight times with 0.4 mg/kg/h albuterol delivered by continuous nebulization over 4 h. One patient withdrew at 3 h after supraventricular tachycardia developed. This subsided promptly on discontinuing albuterol therapy. Heart rate increases were observed in six of eight treatments and serum albuterol levels at the end of treatment were greater than 25.0 ng/ml in all but one treatment. A mean increase in heart rate of 16.3 percent was observed for the entire group. Of the treatments with elevated (> 25.0 ng/ml) serum albuterol levels, a significant cumulative increase in heart rate was observed with time. A significant improvement of FEV1 was observed (p = 0.0025) with a net increase of 36.8 percent. These data suggest that high-dose continuously aerosolized albuterol treatment in some adult asthmatics can result in markedly elevated serum albuterol levels and potential cardiac stimulation despite spirometric improvement.
authors.affiliation: Department of Medicine, St. Vincent's Hospital and Medical Center, New York, New York 10011.
authors.forename: R Y
authors.initials: RY
authors.lastname: Lin
authors.forename: A J
authors.initials: AJ
authors.lastname: Smith
authors.forename: P
authors.initials: P
authors.lastname: Hergenroeder
mesh_terms: D000328:Adult; D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use*; D000628:Aminophylline / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007267:Injections; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D011188:Potassium / Q000097:blood; D013617:Tachycardia, Supraventricular / Q000139:chemically induced*; D014202:Tremor / Q000139:chemically induced
chemical_list: D000336:Aerosols; D000628:Aminophylline; D000420:Albuterol; D011188:Potassium; D008775:Methylprednisolone