Paradoxical bronchospasm in U.S. military veterans with COPD or asthma at a tertiary VA medical center in Chicago, Illinois

Kaul, Malvika; Turner, Karen; Rubinstein, Israel

doi:10.1016/j.resmer.2021.100855

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…Ayed et al reported a patient using terbutaline nebulization to cause dyspnea, cough, wheezing, and hypoxia (85% oxygen saturation), tachycardia ( 110 beats per minute) [1]. All short-acting β2 -adrenoceptor agonists approved by the FDA have warnings about causing paradoxical bronchospasm [4], and the instructions for terbutaline sulfate also suggest that the drug may cause bronchospasm, but the incidence rate the mechanisms are tillunknown. Some studies suggest that bronchospasm caused by β2 -adrenoceptor agonists may be mediated by IgE, and that salbutamol, terbutaline, and pibuterol share common structural features: a tert-butyl group attached to a nitrogen atom may explain that they can all bind to proteins to produce IgE and cause bronchospasm [11][12] .…”

Section: Discussionmentioning

confidence: 99%

“…Elevated plasma levels of lactic acid (lactic acidosis) have also been reported [2][3]. Of concern, bronchospasm may occur in rare cases following inhalation of short-acting beta2 agonists [1,4].No cases have been reported in the Chinese population.Current literature mentions that the short-acting β2adrenoceptor agonists salbutamol, levosalbutamol, terbutaline, ipratropium bromide, salmeterol, and pirbuterol can cause paradoxical bronchospasm [5][6][7][8][9][10], with salbutamol being more common and terbutaline being rare. In this paper, we report a case of severe bronchospasm caused by nebulizer inhalation treatment with terbutaline sulfate.…”

Section: Introductionmentioning

confidence: 99%

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Tremor and Paradoxical bronchospasm caused by Terbutaline

Wang¹,

Liu²,

Liang³

et al. 2023

Preprint

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Background Common adverse reactions of terbutaline include skeletal muscle tremor, headache,tachycardia, palpitations, hypokalemia and so on.Bronchospasm caused by terbutaline is rarely reported. This article reports one case of severe bronchospasm caused by nebulized terbutaline sulfate inhalation therapy. Case presentation A 51-year-old female patient was admitted to hospital with acute bronchitis.The main complaints were cough, sputum and wheezing. She has no history of drug or food allergies. On the day of admission, terbutaline nebulization treatment immediately caused limb tremor and bronchospasm. After glucocorticoid, aminophylline, non-invasive respiratory support and other symptomatic treatments,the patient improved on the 4th day. Conclusion The mechanism of terbutaline leading to bronchospasm is still unclear. The tert-butylline on the chemical structure of terbutaline may bind to proteins to produce IgE-mediated bronchospasm, The excipient ededidine disodium and the osmotic pressure of the nebulized diluent may also lead to bronchospasm. During the clinical treatment, hypotonic nebulizing dilutions should be avoided, and close monitor should be taken in case ofpossible fatal bronchospasm.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tremor and Paradoxical bronchospasm caused by Terbutaline

Wang¹,

Liu²,

Liang³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Three participants showed significant increase in airway resistance following bronchodilator administration which could be attributed to paradoxical bronchoconstriction, where unusual worsening of lung functions occurs following beta-2 agonist administration in patients with obstructive airway disease instead of the expected improvement [21]. The prevalence of paradoxical bronchospasm in subjects aged 7-98 years was reported as 4.4% [22].…”

Section: Open Accessmentioning

confidence: 91%

Lung function assessment in preschool children with symptoms of asthma: A preliminary study

Rajapakse¹,

Agampodi²,

Yasaratne

et al. 2023

Anuradhapura Med. J.

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Background: Asthma causes a significant disease burden in children and it is objectively diagnosed by demonstration of reversible airway obstruction. However, objective diagnosis of airway obstruction in preschool children with asthma symptoms is not frequently practised in Sri Lanka.Methodology: This study was a descriptive cross-sectional preliminary study conducted in a convenience sample of 11 consecutive children aged 3-6 years presenting with symptoms of asthma. Asthma Control Test (ACT) was used to assess symptom control. Lung function assessment was carried out using spirometry and impulse oscillometry (IOS) according to European Respiratory Society and American Thoracic Society guidelines. Airway obstruction cut-off was considered as the forced expiratory volume in the first second (FEV1): forced vital capacity (FVC) ratio less than 0.9.Results: The study sample consisted of 4 boys and 7 girls. Nine participants had good control of asthma symptoms (ACT>19). Only three participants performed spirometry in an acceptable and reproducible manner and two of them demonstrated evidence of airway obstruction. FVC less than 0.8 was noted in two participants probably attributable to poor effort (pseudo-restriction). Significant bronchodilator reversibility was not demonstrable in any patient, and two participants had reduced FEV1:FVC ratio following administration of beta-2-agonists probably due to paradoxical bronchoconstriction or improvement of FVC.IOS assessment was completed successfully by seven children. Increased R5-20 was detected in 3 participants and increased resonance frequency in another two children, suggesting probable peripheral airway involvement.Conclusion: Airway obstruction in preschool children could be assessed using spirometry and IOS. IOS is more feasible in preschool children.

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Paradoxical bronchospasm in U.S. military veterans with COPD or asthma at a tertiary VA medical center in Chicago, Illinois

Cited by 2 publications

References 21 publications

Tremor and Paradoxical bronchospasm caused by Terbutaline

Tremor and Paradoxical bronchospasm caused by Terbutaline

Lung function assessment in preschool children with symptoms of asthma: A preliminary study

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