Recognising and managing albuterol-induced lactic acidosis

Area of Science:

• Medical Case Report
• Pharmacology
• Critical Care Medicine

Background:

• Lactic acidosis is a critical condition often linked to hypoxia or sepsis.
• Beta-adrenergic agonists, like albuterol, can also precipitate lactic acidosis.
• Chronic obstructive pulmonary disease (COPD) exacerbations frequently involve increased use of albuterol.

Purpose of the Study:

• To report a case of lactic acidosis induced by albuterol in a patient with COPD exacerbation.
• To emphasize the importance of considering medication-induced causes for lactic acidosis.
• To highlight the diagnostic challenges and appropriate management strategies.

Main Methods:

• Case presentation of a male patient in his 70s with COPD exacerbation.
• Monitoring of lactate levels and response to albuterol administration.
• Exclusion of sepsis through comprehensive diagnostic workup.

Main Results:

• The patient exhibited elevated lactate levels that worsened after albuterol treatment.
• Sepsis workup yielded negative results, ruling out infection as the cause.
• Lactate levels normalized after reducing the frequency of albuterol administration.

Conclusions:

• Albuterol can induce lactic acidosis, especially in patients with respiratory conditions.
• Clinicians should consider medication side effects in the differential diagnosis of lactic acidosis.
• Prompt recognition can prevent unnecessary investigations and guide appropriate treatment adjustments.