Cardiovascular Effects after Inhalation of Large Doses of Albuterol Dry Powder in Rats, Monkeys, and Dogs: A Species Comparison

Petruska, Janet; Beattie, J. Gregory; Stuart, B.O.; Pai, Sudhakar M.; Walters, Karen; Banks, Christopher M.; Lulham, G.; Mirro, Elmer J.

doi:10.1006/faat.1997.2370

Cited by 20 publications

(7 citation statements)

References 38 publications

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“…Similar histopathological findings were present in a study in which administration of clenbuterol to rats induced irreversible myocyte and soleus muscle necrosis 17 . Albuterol, like other drugs in its class, can increase skeletal muscle mass and reduce body fat 18 . Because skeletal muscle contains a significant proportion of beta‐adrenoceptors, it is suspected that the muscle remodeling induced by excessive beta‐2 agonism led to muscle necrosis and rhabdomyolysis 19 .…”

Section: Discussionsupporting

confidence: 65%

Acute nontraumatic rhabdomyolysis in a Greyhound after albuterol toxicosis

Granfone

Walker

2021

J Vet Emergen Crit Care

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Objective To describe the clinical features of rhabdomyolysis due to albuterol toxicosis in a Greyhound. Case summary A 4‐year‐old neutered male Greyhound was presented for albuterol toxicosis leading to severe hypokalemia and respiratory paralysis. After 3 hours of mechanical ventilation, pigmenturia and marked enlargement, firmness, and pain of the left thigh muscles were noted. Severe hyperkalemia and cardiac arrhythmias were identified after turning the patient. After discontinuation of mechanical ventilation, other muscles became involved, and the patient developed acute kidney injury and concern for multiple organ dysfunction syndrome over the next 5 days. On day 6, the patient was euthanized, and necropsy revealed myocardial and skeletal muscle necrosis, myoglobinuria, and acute tubular degeneration. New or unique information provided To the authors’ knowledge, this is the first case of albuterol toxicosis leading to rhabdomyolysis.

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Section: Discussionsupporting

confidence: 65%

Acute nontraumatic rhabdomyolysis in a Greyhound after albuterol toxicosis

Granfone

Walker

2021

J Vet Emergen Crit Care

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“…Experimental studies have demonstrated species‐specific cardiac lesions in dogs associated with albuterol administration and subsequent tachycardia. Petruska et al demonstrated slight to moderate fibrosis of the papillary muscles of the left ventricle in dogs receiving ≥19 times the clinical dose of albuterol dry powder via inhalation 12 …”

Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of albuterol inhalant exposure in dogs: 36 cases (2007–2017)

Meroni

Khorzad²,

Bracker

et al. 2020

J Vet Emergen Crit Care

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Objective To describe the clinical features, clinicopathological features, treatment, and outcome of dogs presented for albuterol exposure. Design Retrospective case series from January 2007 to December 2017. Setting Tertiary veterinary facility. Animals Thirty‐six client‐owned dogs presenting for known or suspected albuterol exposure secondary to chewing on albuterol metered‐dose inhalers (MDIs). Interventions None. Measurements and main results All dogs presented with clinical signs attributable to albuterol exposure. The most common physical examination abnormality was sinus tachycardia, noted in 34 of 36 (94%) dogs. Twenty‐seven patients (75%) were admitted to the hospital for therapy, with a median length of hospitalization of 20.5 hours (16.75–24.5). Thirty‐two of 36 dogs had serum electrolytes evaluated at admission, with 22 of 32 (69%) presenting with hypokalemia ([K+] < 3.62 mmol/L]). Hyperlactatemia ([lactate] > 2.80 mmol/L) was noted in 23 of 28 (82%) dogs. A negative correlation was found between serum lactate and potassium (r = –0.64, r2 = 0.40, P = 0.0003). Hyperglycemia ([glucose] > 6.44 mmol/L) was noted in 20 of 30 (67%) dogs. Beta antagonist therapy was utilized in 20 of 36 (56%) of dogs. Conclusions Although uncommon, albuterol intoxication can lead to significant clinical and electrolyte abnormalities. Albuterol‐induced hypokalemia and associated tachyarrhythmias can be successfully managed, and albuterol intoxication has an excellent prognosis for survival to discharge. A minimum database should be evaluated in all dogs presenting for suspected albuterol exposure, with lactate and glucose monitored carefully in dogs with moderate or severe hypokalemia given the correlation found.

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“…Transient hypokalemia may also precipitate the development of dysrhythmias. [126][127][128] Pronounced hypotension with myocardial impairment can be achieved in very high doses under experimental conditions. 95,[128][129][130] Similarly, elevations in biomarkers of cardiac injury have been observed in humans, but these seem to be transient.…”

Section: Nonselective -Agonists and 2 -Agonistsmentioning

confidence: 99%

“…[126][127][128] Pronounced hypotension with myocardial impairment can be achieved in very high doses under experimental conditions. 95,[128][129][130] Similarly, elevations in biomarkers of cardiac injury have been observed in humans, but these seem to be transient. 131,132 Besides their use as bronchodilators, 2 -agonists are also used systemically in obstetrics for the management of premature labor.…”

Section: Nonselective -Agonists and 2 -Agonistsmentioning

confidence: 99%

Comprehensive review of cardiovascular toxicity of drugs and related agents

Mladěnka

Applová

Patočka

et al. 2018

Medicinal Research Reviews

203

120

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Cardiovascular diseases are a leading cause of morbidity and mortality in most developed countries of the world. Pharmaceuticals, illicit drugs, and toxins can significantly contribute to the overall cardiovascular burden and thus deserve attention. The present article is a systematic overview of drugs that may induce distinct cardiovascular toxicity. The compounds are classified into agents that have significant effects on the heart, blood vessels, or both. The mechanism(s) of toxic action are discussed and treatment modalities are briefly mentioned in relevant cases. Due to the large number of clinically relevant compounds discussed, this article could be of interest to a broad audience including pharmacologists and toxicologists, pharmacists, physicians, and medicinal chemists. Particular emphasis is given to clinically relevant topics including the cardiovascular toxicity of illicit sympathomimetic drugs (e.g., cocaine, amphetamines, cathinones), drugs that prolong the QT interval, antidysrhythmic drugs, digoxin and other cardioactive steroids, beta‐blockers, calcium channel blockers, female hormones, nonsteroidal anti‐inflammatory, and anticancer compounds encompassing anthracyclines and novel targeted therapy interfering with the HER2 or the vascular endothelial growth factor pathway.

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Cardiovascular Effects after Inhalation of Large Doses of Albuterol Dry Powder in Rats, Monkeys, and Dogs: A Species Comparison

Cited by 20 publications

References 38 publications

Acute nontraumatic rhabdomyolysis in a Greyhound after albuterol toxicosis

Acute nontraumatic rhabdomyolysis in a Greyhound after albuterol toxicosis

Retrospective evaluation of albuterol inhalant exposure in dogs: 36 cases (2007–2017)

Comprehensive review of cardiovascular toxicity of drugs and related agents

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