Is there a need to treat hypokalaemia associated with intravenous salbutamol infusion?
OBJECTIVE
To investigate the evolution of metabolic effects associated with intravenous salbutamol infusion given together with 2 doses of intramuscular steroids in the treatment of preterm labour.


METHODS
Preterm labour was inhibited with an intravenous infusion of salbutamol in 8 women between 26 and 32(+6) weeks with normal singleton pregnancies. Serum glucose concentration, serum potassium, sodium and insulin concentrations, and total white cell count both during the infusion as well as post-therapy, were plotted against time.


RESULTS
Intravenous salbutamol infusion administered at a rate required to inhibit uterine contractions in preterm labour causes a rise in serum glucose and plasma insulin concentrations. The serum glucose and plasma insulin levels peaked soon after cessation of therapy and took 2-3 hours to come to pre-infusion levels. The decline in serum potassium concentration was gradual and plateaued after 2 hours. Once the salbutamol infusion was stopped the potassium levels were back to normal by 2 hours. There is an increase in total white cell count within an hour of the initiation of therapy.


CONCLUSIONS
There is no need to administer insulin for hyperglycaemia and/or potassium for hypokalaemia unless the patient is a known diabetic or when a patient needs immediate surgery.
Chua
S
S
Department of Obstetrics and Gynaecology, National University of Singapore, National University Hospital, Singapore.
Razvi
K
K
Wong
M T
MT
Tay
R
R
Arulkumaran
S
S
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects / Q000378:metabolism; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced*; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011188:Potassium / Q000097:blood / Q000378:metabolism; D011247:Pregnancy; D011263:Pregnancy Trimester, Third
D000318:Adrenergic beta-Agonists; D001786:Blood Glucose; D007328:Insulin; D003907:Dexamethasone; D000420:Albuterol; D011188:Potassium