Adrenergic bronchodilator overdose

 

Definition

Adrenergic bronchodilators are inhaled medicines that help open up the air passages. They are used to treat asthma and chronic bronchitis. Adrenergic bronchodilator overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

  • Albuterol
  • Bitolterol
  • Ephedrine
  • Epinephrine
  • Isoetharine
  • Isoproterenol
  • Metaproterenol
  • Pirbuterol
  • Racepinephrine
  • Ritodrine
  • Terbutaline

Note: This list may not be all-inclusive.

Where Found

  • Albuterol (Proventil, Ventolin)
  • Bitolterol (Tornalate)
  • Ephedrine (Ephed II)
  • Epinephrine (Adrenalin, AsthmaHaler, Bronitin Mist, Bronkaid Mist, Medihaler-Epi, Primatene Mist, EpiPen Auto-Injector, Sus-Phrine, Twinject)
  • Ethylnorepinephrine (Bronkephrine)
  • Isoetharine (Arm-a-Med Isoetharine, Bronkometer, Bronkosol, Dey-Dose Isoetharine, Dispos-a-Med Isoetharine, Dey-Lute Isoetharine)
  • Isoproterenol (Aerolone, Dey-Dose Isoproterenol, Dispos-a-Med Isoproterenol, Isuprel, Medihaler-Iso, Norisodrine Aerotrol, Vapo-Iso)
  • Metaproterenol (Alupent, Arm-a-Med Metaproterenol, Dey-Dose Metaproterenol, Dey-Lute Metaproterenol, Metaprel)
  • Pirbuterol (Maxair)
  • Racepinephrine (AsthmaNefrin, Dey-Dose Racepinephrine, Vaponefrin)
  • Terbutaline (Breathaire, Brethine, Bricanyl)

Note: This list may not be all-inclusive.

Symptoms

Airways and lungs:

Bladder and kidneys:

Eyes, ears, nose, and throat:

Heart and blood vessels:

  • High blood pressure, which then leads to low blood pressure
  • Rapid heartbeat

Nervous system:

  • Chills
  • Coma
  • Convulsions
  • Fever
  • Irritability
  • Nervousness
  • Tingling of hands and feet
  • Tremor

Skin:

Stomach and intestines:

  • Nausea
  • Vomiting

Home Care

Seek immediate medical help.

Before Calling Emergency

Determine the following information:

  • Patient's age, weight, and condition
  • The name of the product (ingredients and strengths if known)
  • Time it was swallowed
  • The amount swallowed

Poison Control What to Expect at the Emergency Room

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See: Poison control center - emergency number

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:

  • Activated charcoal
  • Blood and urine tests
  • Breathing support
  • X-rays
  • EKG (electrocardiogram, or heart tracing)
  • Intravenous (through the vein) fluids
  • Laxative
  • Tube placed down the nose and into the stomach (gastric lavage)

Blood tests may show changes in blood sugar and low potassium levels.

Outlook (Prognosis)

Survival past 24 hours is usually a good sign that recovery will follow.

Prevention

Keep all medications in childproof containers out of the reach of children.

References

Akhtar J, Rittenberger JC. Clinical neurotoxicology. In: Shannon MW, Borron SW, Burns MJ. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 10.


Review Date: 10/15/2013
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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