Salbutamol Metered-Dose Inhaler With Spacer for Hyperkalemia

Mandelberg, Avigdor; Krupnik, Zipora; Houri, Sion; Smetana, Shmuel; Gilad, Emil; Matas, Zipora; Priel, Israel E.

doi:10.1378/chest.115.3.617

Cited by 85 publications

(67 citation statements)

References 30 publications

(55 reference statements)

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“…10 actuations gives 1000 µg) and inhalation time was ~2 min (10 breaths). This spacer technique was utilised to maximise respiratory drug delivery, although complete uptake of salbutamol cannot be concluded as any residual salbutamol in the spacer, mouth or remaining in the lung was not measured (Mandelberg et al 1999). Salbutamol administration was performed 30 min prior to exercise commencement, allowing for maximum pharmacological activity (Hopkins 1999).…”

Section: Salbutamol and Placebo Administrationmentioning

confidence: 99%

Salbutamol effects on systemic potassium dynamics during and following intense continuous and intermittent exercise

et al. 2016

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Section: Salbutamol and Placebo Administrationmentioning

confidence: 99%

Salbutamol effects on systemic potassium dynamics during and following intense continuous and intermittent exercise

et al. 2016

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“…3,5 The onset of action is usually within 15-30 min, with a peak effect between 30 and 60 min, and its effect lasts for 4-6 h. 3,5,12 The onset time and the duration of its hypokalemic effect are similar to those of insulin and sodium bicarbonate. 12 In this case, we administered a total of 20 g of nebulized salbutamol over two cycles.…”

Section: Discussionmentioning

confidence: 99%

“…5,21 Although this response is minor (0.15 mEq l −1 ) 5 or transient (less than 3 min), 5,21 in cases of excessive hyperkalemia, it is prudent to administer calcium salts immediately before initiating nebulized salbutamol.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of a selective β 2 -agonist, such as salbutamol, in lowering serum potassium has been established in normal volunteers 4 and in chronic renal failure patients. [5][6][7][8][9] However, there are no data regarding its potential efficacy as a treatment option for hyperkalemia as a result of OLT, especially during the anhepatic stage. We report the successful use of nebulized salbutamol in combination with conventional treatments to prevent a life-threatening increase in serum potassium during the pre-anhepatic stage in LDLT.…”

Section: Résumémentioning

confidence: 99%

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Salbutamol to facilitate management of acute hyperkalemia in liver transplantation: a case report

Kim

Chang

Yun

et al. 2008

Can J Anesth/J Can Anesth

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“…As a #2 agonist, it binds to #2 receptors in the liver and muscle cells creating a chain reaction, which results in stimulation of the sodiumpotassium pump (Ahee and Crowe, 2000). A decrease in potassium levels occurs within 1-2 minutes, with the peak effect being reached after 40-80 minutes (Mandelberg et al, 1999)-a faster effect than that of insulin.…”

Section: Salbutamolmentioning

confidence: 99%

Prehospital treatment of hyperkalaemia

Strange

2010

Journal of Paramedic Practice

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This article explores the assessment and management considerations of patients with hyperkalaemia. Using a case study from clinical practice, the hospital treatment is reviewed with particular emphasis upon the use of calcium, insulin and dextrose. In particular, potential prehospital treatments are considered, with focus upon the use of salbutamol and furosemide. Definitions, incidence and mortality rates of hyperkalaemia are also detailed. The signs, symptoms and causes of the condition are examined, with the aim of achieving prehospital diagnosis in the absence of serum potassium levels. Hyperkalaemic electrocardiogram (ECG) changes are studied and examples are given. Conclusions are made, including a recommendation for the prehospital use of salbutamol in the treatment of hyperkalaemia. (Khedr et al, 2009). A clear understanding of the emergency management is crucial as hyperkalaemia has lethal consequences and is associated with a mortality rate of 14-41% (Feld and Kaskel, 2010). Furthermore, severe hyperkalaemia, if not treated rapidly, carries a mortality rate of 67% (Weisberg, 2008), providing a compelling argument for treating the condition in the prehospital phase. Key wordsl Diagnosis Signs and symptomsTo carry out appropriate management of hyperkalaemic patients, an understanding of the signs and symptoms is fundamental. An increased concentration of potassium in the plasma has the effect of depolarizing cell membranes, therefore making them less excitable and in turn, resulting in neuromuscular dysfunction (Lubin et al, 2006). Patients with hyperkalaemia can display abnormal signs and symptoms specific to the renal, gastrointestinal, cardiovascular and nervous systems (LeFever Kee et al, 2009). They can present with nausea, abdominal pain and or/diarrhoea (Guy, 2009); but also muscle irritability, malaise, muscle weakness and, in patients with serum potassium levels of greater than 6.0 mEq/L, paresthesia and an increased heart rate (LeFever Kee et al, 2009).Despite such an array of symptoms, it is commonly documented that, even with severe hyperkalaemia, patients can present with no abnormalities (Gleadle, 2007;Baltazar, 2009). This would explain Mrs Y's asymptomatic presentation, making diagnosing the condition in the prehospital environment difficult, if not impossible. BloodsIn Mrs Y's case, the diagnosis had been made on the basis of blood results and a history of reduced renal function-a well recognized cause of hyperkalaemia (Irwin and Rippe, 2008). In the presence of normal renal function, the attending doctor would suspect 'pseudohyperkalaemia', a condition in which abnormal potassium levels are the result of haemolysis in-vitro (Irwin and Rippe, 2008). However, such factors are not of concern to UK paramedics as, despite evidence-based approval (Prause et al, 1997), blood gas and electrolyte testing is currently unavailable in the prehospital stage. The ECGWithout the help of serum potassium results and without the benefit of specific signs and symptoms, diagnosing hyperkalaemia in...

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Salbutamol Metered-Dose Inhaler With Spacer for Hyperkalemia

Cited by 85 publications

References 30 publications

Salbutamol effects on systemic potassium dynamics during and following intense continuous and intermittent exercise

Salbutamol effects on systemic potassium dynamics during and following intense continuous and intermittent exercise

Salbutamol to facilitate management of acute hyperkalemia in liver transplantation: a case report

Prehospital treatment of hyperkalaemia

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