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Albuterol overdose: a case report and differential diagnosis
W D King1, M Holloway, P A Palmisano
1Children's Hospital of Alabama, Regional Poison Control Center, Birmingham 35233.
Pediatric Emergency Care
|October 1, 1992
Summary
Large overdoses of albuterol, a common asthma medication, can cause significant toxicity in young children. Despite severe symptoms like agitation and hyperglycemia, outcomes are typically benign.
Area of Science:
- Pharmacology
- Toxicology
- Pediatrics
Background:
- Selective beta 2 agonists are first-line asthma treatments.
- Increased use has led to more reported overdoses and therapeutic errors.
Observation:
- A 22-month-old child ingested a large albuterol overdose.
- The child developed agitation, tremulousness, hyperglycemia (>320 mg/dl), ketonuria, and hypokalemia.
Findings:
- Albuterol toxicity can manifest with hyperglycemia and hypokalemia, typically seen in diabetics or pregnant patients.
- Differential diagnosis for overdose symptoms includes hyperglycemia, hypokalemia, agitation, and tremulousness.
- The exposure-case fatality rate (ECFR) suggests beta 2 agonist overdoses, while serious, usually have benign outcomes.
Implications:
- Highlights the potential for severe toxicity from common asthma medications in children.
- Emphasizes the need for careful dosing and monitoring of beta 2 agonists.
- Provides a framework for assessing drug toxicity using ECFR.