Salbutamol misuse or abuse with fatal outcome: A case-report

Boucher, Alexandra; Payen, Christine; Garayt, Christelle; Ibanez, Hervé; A, Dieny; Doche, Christophe; Chuniaud, Christine; Descotes, Jacques

doi:10.1177/0960327110388957

Cited by 17 publications

(12 citation statements)

References 13 publications

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“…The clenbuterol, polydrug, fatalities’ issues identified are consistent with previous findings . Conversely, consistent with only a single report of salbutamol abuse‐related fatality having been previously described , the molecule is usually considered safer than clenbuterol. Indeed, suprapharmacological plasma concentrations of salbutamol could be well tolerated, without serious cardiac arrhythmias or any fatalities being reported from a UK cohort of 17 salbutamol overdose cases .…”

Section: Discussionsupporting

confidence: 88%

β‐2 Agonists as Misusing Drugs? Assessment of both Clenbuterol‐ and Salbutamol‐related European Medicines Agency Pharmacovigilance Database Reports

Milano

Chiappini

Mattioli

et al. 2018

Basic Clin Pharma Tox

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A recent years' increase in misusing levels of image- and performance- enhancing drugs (IPEDs) has been observed. Out of these drugs, beta-2 agonists have recently emerged for their potential of misuse, especially for slimming and bodybuilding purposes. To this perspective, clenbuterol ('the size zero pill') has been reported as being both popular and widely available from the illegal market. All clenbuterol and salbutamol misuse/abuse/dependence/withdrawal/overdose/off-label spontaneous reports (2006-2016) from the European Medicines Agency (EMA) EudraVigilance (EV) database were collected and analysed by age range, gender, concomitant therapies and source of information. From the EV database, 55 of a total number of 920 'suspect' misuse/abuse/dependence/withdrawal/overdose/off-label ADRs (e.g. 5.97%; corresponding to 25 of 138 individuals) and 1310 of 62,879 ADRs (e.g. 2.08%; corresponding to 474 of 6923 individuals) were, respectively, associated with clenbuterol (typically ingested in combination with a range of anabolic steroids) and salbutamol. Proportional reporting ratio (PRR) value for misuse/abuse ADRs was higher (PRR = 18.38) for clenbuterol in comparison with salbutamol. Clenbuterol misuse/abuse could be a cause for major concern, especially in vulnerable individuals.

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Section: Discussionsupporting

confidence: 88%

β‐2 Agonists as Misusing Drugs? Assessment of both Clenbuterol‐ and Salbutamol‐related European Medicines Agency Pharmacovigilance Database Reports

Milano

Chiappini

Mattioli

et al. 2018

Basic Clin Pharma Tox

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“… [8] Furthermore, sinus tachycardia and tachyarrhythmias were defined in several case reports. [9] In our case, we observed sinus tachycardia on admission and SVT followed by VF development. Fortunately, the patient responded to defibrillation.…”

Section: Discussionsupporting

confidence: 49%

Salbutamol Abuse is Associated with Ventricular Fibrillation

Uysal

Solak

Carus

et al. 2015

Turkish Journal of Emergency Medicine

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SUMMARYSalbutamol-induced cardiac complications are well-established. Herein, we describe a case of a 24-year female who was admitted to the emergency department because of a suicide attempt with salbutamol (76 mg). Salbutamol abuse induced the development of supraventricular tachycardia and ventricular fibrillation. Regular sinus rhythm was restored with defibrillation. The hypokalemic patient who stayed in the intensive care unit was discharged after 48 hours of hospitalization.

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“…Its adverse effects are dose-dependent and may include dysrhythmias and myocardial injury, headache, abdominal pain, nausea, and rhabdomyolysis [ 136 , 146 , 147 , 148 ]. Reports relating to salbutamol misuse have been less frequently mentioned [ 149 , 150 , 151 ]. Similar to clenbuterol, salbutamol’s adverse effects are dose-related and may include tremor, restlessness, anxiety/agitation, tachycardia, atrial fibrillation, and myocardial ischaemia, especially in cases of overdosage, chronic use, or intravenous injection [ 152 ].…”

Section: Resultsmentioning

confidence: 99%

Abuse of Prescription Drugs in the Context of Novel Psychoactive Substances (NPS): A Systematic Review

et al. 2018

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Recently, a range of prescription and over-the-counter drugs have been reportedly used as Novel Psychoactive Substances (NPS), due to their potential for abuse resulting from their high dosage/idiosyncratic methods of self-administration. This paper provides a systematic review of the topic, focusing on a range of medications which have emerged as being used recreationally, either on their own or in combination with NPS. Among gabapentinoids, pregabalin may present with higher addictive liability levels than gabapentin, with pregabalin being mostly identified in the context of opioid, polydrug intake. For antidepressants, their dopaminergic, stimulant-like, bupropion activities may explain their recreational value and diversion from the therapeutic intended use. In some vulnerable clients, a high dosage of venlafaxine (‘baby ecstasy’) is ingested for recreational purposes, whilst the occurrence of a clinically-relevant withdrawal syndrome may be a significant issue for all venlafaxine-treated patients. Considering second generation antipsychotics, olanzapine appears to be ingested at very large dosages as an ‘ideal trip terminator’, whilst the immediate-release quetiapine formulation may possess proper abuse liability levels. Within the image- and performance- enhancing drugs (IPEDs) group, the beta-2 agonist clenbuterol (‘size zero pill’) is reported to be self-administered for aggressive slimming purposes. Finally, high/very high dosage ingestion of the antidiarrhoeal loperamide has shown recent increasing levels of popularity due to its central recreational, anti-withdrawal, opiatergic effects. The emerging abuse of prescription drugs within the context of a rapidly modifying drug scenario represents a challenge for psychiatry, public health and drug-control policies.

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Salbutamol misuse or abuse with fatal outcome: A case-report

Cited by 17 publications

References 13 publications

β‐2 Agonists as Misusing Drugs? Assessment of both Clenbuterol‐ and Salbutamol‐related European Medicines Agency Pharmacovigilance Database Reports

β‐2 Agonists as Misusing Drugs? Assessment of both Clenbuterol‐ and Salbutamol‐related European Medicines Agency Pharmacovigilance Database Reports

Salbutamol Abuse is Associated with Ventricular Fibrillation

Abuse of Prescription Drugs in the Context of Novel Psychoactive Substances (NPS): A Systematic Review

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