Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists
Introduction: Salbutamol and terbutaline are short-acting β2 adrenergic agonists that produce bronchial smooth muscle relaxation and are widely used in obstructive pulmonary diseases. Nevertheless, their use has been the cause of a paradoxical bronchoconstriction, which is a rare and potentially ser...
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| Format: | Article |
| Language: | English |
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AboutScience Srl
2020-10-01
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| Series: | Drug Target Insights |
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| Online Access: | https://journals.aboutscience.eu/index.php/dti/article/view/2188 |
| _version_ | 1818759552202440704 |
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| author | Khadija Ayed Islam Latifa Hadi Khalifa Salma Mokaddem Saloua Ben Khamsa Jameleddine |
| author_facet | Khadija Ayed Islam Latifa Hadi Khalifa Salma Mokaddem Saloua Ben Khamsa Jameleddine |
| author_sort | Khadija Ayed |
| collection | DOAJ |
| description | Introduction: Salbutamol and terbutaline are short-acting β2 adrenergic agonists that produce bronchial smooth muscle relaxation and are widely used in obstructive pulmonary diseases. Nevertheless, their use has been the cause of a paradoxical bronchoconstriction, which is a rare and potentially serious adverse reaction. The aim of this study is to report a case of paradoxical bronchoconstriction caused by β2 adrenergic agonists.
Methods: This case is about a 50-year-old asthmatic patient who describes a history of repeated acute asthma attacks after salbutamol inhalation or terbutaline nebulization. A double-blind crossover study was performed over 3 days, in order to compare the effects of each bronchodilator. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and maximal expiratory flow 25-75 (MEF25-75) were measured.
Results: On the first day, a bronchoconstriction caused by deep and repeated inhalations was eliminated. On the second day, an airway obstruction was confirmed by a decrease in FEV1 at 40% from baseline values after nebulization of a standard dose of terbutaline. On the third day, a spirometry was performed before and after nebulization of a standard dose of ipratropium bromide, and there were no significant changes in the spirometric parameters. Finally the patient was discharged with a written warning mentioning the danger of salbutamol and terbutaline use.
Conclusion: Salbutamol and terbutaline are generally well-tolerated β2 adrenergic agonists. Nevertheless, in rare cases, these substances can cause a paradoxical bronchoconstriction. Doctors must therefore remain vigilant about its side effect and possibly investigate each case. |
| first_indexed | 2024-12-18T06:44:32Z |
| format | Article |
| id | doaj.art-282d4977aa1f4d6a8fac32e2b6e4ba46 |
| institution | Directory Open Access Journal |
| issn | 1177-3928 |
| language | English |
| last_indexed | 2024-12-18T06:44:32Z |
| publishDate | 2020-10-01 |
| publisher | AboutScience Srl |
| record_format | Article |
| series | Drug Target Insights |
| spelling | doaj.art-282d4977aa1f4d6a8fac32e2b6e4ba462022-12-21T21:17:31ZengAboutScience SrlDrug Target Insights1177-39282020-10-0114110.33393/dti.2020.2188Paradoxical bronchoconstriction caused by β2-adrenoceptor agonistsKhadija Ayed0Islam Latifa Hadi Khalifa1Salma Mokaddem2Saloua Ben Khamsa Jameleddine3Department of Physiology, Faculty of Medicine of Tunis, University of Tunis el Manar, Tunis - TunisiaDepartment of Physiology, Faculty of Medicine of Tunis, University of Tunis el Manar, Tunis - TunisiaDepartment of Physiology, Faculty of Medicine of Tunis, University of Tunis el Manar, Tunis - TunisiaDepartment of Physiology, Faculty of Medicine of Tunis, University of Tunis el Manar, Tunis - TunisiaIntroduction: Salbutamol and terbutaline are short-acting β2 adrenergic agonists that produce bronchial smooth muscle relaxation and are widely used in obstructive pulmonary diseases. Nevertheless, their use has been the cause of a paradoxical bronchoconstriction, which is a rare and potentially serious adverse reaction. The aim of this study is to report a case of paradoxical bronchoconstriction caused by β2 adrenergic agonists. Methods: This case is about a 50-year-old asthmatic patient who describes a history of repeated acute asthma attacks after salbutamol inhalation or terbutaline nebulization. A double-blind crossover study was performed over 3 days, in order to compare the effects of each bronchodilator. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and maximal expiratory flow 25-75 (MEF25-75) were measured. Results: On the first day, a bronchoconstriction caused by deep and repeated inhalations was eliminated. On the second day, an airway obstruction was confirmed by a decrease in FEV1 at 40% from baseline values after nebulization of a standard dose of terbutaline. On the third day, a spirometry was performed before and after nebulization of a standard dose of ipratropium bromide, and there were no significant changes in the spirometric parameters. Finally the patient was discharged with a written warning mentioning the danger of salbutamol and terbutaline use. Conclusion: Salbutamol and terbutaline are generally well-tolerated β2 adrenergic agonists. Nevertheless, in rare cases, these substances can cause a paradoxical bronchoconstriction. Doctors must therefore remain vigilant about its side effect and possibly investigate each case.https://journals.aboutscience.eu/index.php/dti/article/view/2188AsthmaBronchoconstrictionBronchodilatorsβ-2 adrenergic agonistsSpirometry |
| spellingShingle | Khadija Ayed Islam Latifa Hadi Khalifa Salma Mokaddem Saloua Ben Khamsa Jameleddine Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists Drug Target Insights Asthma Bronchoconstriction Bronchodilators β-2 adrenergic agonists Spirometry |
| title | Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists |
| title_full | Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists |
| title_fullStr | Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists |
| title_full_unstemmed | Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists |
| title_short | Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists |
| title_sort | paradoxical bronchoconstriction caused by β2 adrenoceptor agonists |
| topic | Asthma Bronchoconstriction Bronchodilators β-2 adrenergic agonists Spirometry |
| url | https://journals.aboutscience.eu/index.php/dti/article/view/2188 |
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