Recognising and managing albuterol-induced lactic acidosis

Lactic acidosis is a serious condition often associated with tissue hypoxia or sepsis, but it can also be caused by beta-adrenergic agonists such as albuterol. This report describes a case of albuterol-induced lactic acidosis in a male patient in his 70s with chronic obstructive pulmonary disease exacerbation. The patient presented with progressively worsening dyspnoea and increased albuterol use. During the initial evaluation, an elevated lactate level was observed, which further increased after albuterol treatment in the emergency room. A thorough sepsis workup was performed, yielding negative results, which ultimately led to the diagnosis of albuterol-induced lactic acidosis. After reducing the frequency of albuterol treatments, the patient's lactate levels normalised. This case underscores the importance of considering medication-induced causes of lactic acidosis, particularly in patients with respiratory conditions who are frequently administered beta-adrenergic agonists. Recognising this under-reported phenomenon can help clinicians avoid unnecessary sepsis workups and ensure more accurate treatment plans.