A STUDY OF SELF-POISONING WITH ORAL SALBUTAMOL - LABORATORY AND CLINICAL-FEATURES

1 The recent increase in asthma mortality coupled with reports of fata l asthma associated with beta-2-agonist therapy, has stimulated intere st in the plasma concentrations of beta-2-agonists that produce system ic toxicity. 2 We prospectively studied 17 patients (9 male), mean age 23 years (range 2-72), who attended the emergency departments of hosp itals throughout the United Kingdom having recently ingested an overdo se of salbutamol. 3 Clinical, laboratory, ECG data, plasma and urine s amples were obtained from each patient. Plasma was assayed for salbuta mol concentration using a high performance TLC-photodensitometric meth od. 4 The mean (+/- s,d.) salbutamol dose reported to have been ingest ed was 89(+ 83)mg and the mean plasma salbutamol concentration was 166 (range 18-449) ng ml-1. The mean plasma potassium was 2.9 (s.d. +/- 0 .6) mm (n = 16). None of the patients in this study developed serious cardiac dysrrhythmias. 5 There were significant correlations between t he plasma salbutamol concentration and plasma potassium concentration (r = -0.85; P < 0.00005) and between plasma salbutamol concentration a nd pulse rate (r = 0.66; P < 0.005). 6 We conclude that in these patie nts, without respiratory decompensation, suprapharmacological plasma c oncentrations of salbutamol were tolerated without serious cardiac arr hythmias or any fatalities.