Salbutamol misuse or abuse with fatal outcome: a case-report.
Salbutamol is a short-acting agonist of the β(2) adrenergic receptors sometimes misused or abused, which can result in various cardiovascular adverse effects. We report one case of fatal salbutamol misuse or abuse in a 36-year-old poorly controlled female asthmatic patient with a past medical history of alcoholism and a recent smoking cessation. She died shortly after hospital admission following acute dyspnea and sudden collapse at home. Toxicological analyses evidenced salbutamol overdose, and necropsy showed acute lung edema and marked dysplasia of the right ventricle and revealed the patient was pregnant. The involvement of an initial disorder of the ventricular rhythm leading to cardiac failure is suggested by the presence of several combined pro-arrhythmogenic factors, such as arrhythmogenic right ventricle dysplasia, hypoxemia related to bronchospasm and salbutamol overdose.
Poison Center and Pharmacovigilance Department, Lyon University Hospitals, Lyon, France. alexandra.boucher@chu-lyon.fr
Alexandra
A
Boucher
Christine
C
Payen
Christelle
C
Garayt
Hervé
H
Ibanez
Anne
A
Dieny
Christophe
C
Doche
Christine
C
Chuniaud
Jacques
J
Descotes
D058666:Adrenergic beta-2 Receptor Agonists / Q000506:poisoning*; D000328:Adult; D000420:Albuterol / Q000506:poisoning*; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D062787:Drug Overdose; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular
D058666:Adrenergic beta-2 Receptor Agonists; D000420:Albuterol