Unusual vascular reactions to albuterol

Two patients experienced previously undescribed vascular reactions to albuterol sulfate inhalation. Features of the first reaction suggest mast-cell degranulation and were reversed by epinephrine. The second patient experienced severe postural hypotension corresponding to albuterol's duration of action. Vasoactive mediators or unusual vascular sensitivity to beta 2-drugs may be implicated in these reactions.