Inadvertent Salbutamol Overdose Presenting as Acute Toxicity

Salbutamol is a short-acting beta-2 agonist available in inhalational and oral formulations for the treatment of asthma and chronic obstructive pulmonary disease due to its ability to rapidly relieve bronchospasm. However, because of its quick onset of action, it is recommended only as rescue therapy in mild cases with minimal symptoms and without nocturnal awakenings. Owing to its efficacy, salbutamol carries a potential risk of misuse or overuse among asthmatic patients. We report the case of a young woman with a long-standing history of asthma who presented with seizures followed by loss of consciousness after consuming multiple salbutamol tablets in succession. Neuroimaging (MRI brain) and electroencephalogram findings were normal. Further evaluation revealed cardiac arrhythmias, metabolic dysfunction characterized by hyperglycemia and lactic acidosis, and hypokalemia. She was managed conservatively in the ICU. After stabilization, her asthma medications were optimized, and she was discharged with education on the appropriate use of salbutamol to prevent recurrence of toxicity.