Ipratropium bromide/salbutamol/levosalbutamol/salbutamol
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Cardiac toxicities: 16 case reports In a retrospective cohort study consisting of 1296 patients who were hospitalised for status asthamaticus from January 2012 to December 2016, 16 patients aged 5-16 years [sexes not stated] were described who developed diastolic hypotension, supraventricular tachycardia (SVT), right ventricular hypertrophy (RVH), premature ventricular contraction (PVC), left ventricular hypertrophy (LVH), premature atrial contraction (PAC), sinus arrhythmia, ST elevation, prolonged QT interval, TU fusion or T wave inversion following treatment with ipratropium bromide/salbutamol, levosalbutamol or salbutamol for status asthmaticus [not all routes, dosages and time to reaction onsets stated]. The patients, who had asthma, were hospitalised with status asthmaticus. They started receiving salbutamol [albuterol] (n=14); levosalbutamol [Xopenex] (n=1); and ipratropium bromide/salbutamol [Duoneb] (n=1). However, 0.5-46.5 hours later, the patients developed diastolic hypotension (n=10); SVT (n=2); PVC (n=2); and irregular rhythm (n=2). At that time the patients had received total 185-930mg of salbutamol. Based on the blood pressure measurement, electrocardiogram and echocardiogram findings, the patients were diagnosed with diastolic hypotension (n=10), SVT (n=1); RVH and SVT (n=1); PVC and LVH (n=1); PVC, PAC and LVH (n=1); sinus arrhythmia, ST elevation, borderline prolonged QT interval and TU fusion (n=1); and sinus arrhythmia, prolonged QT interval and T wave inversion (n=1). These events were suspected to be secondary to treatment with salbutamol and levosalbutamol. All patients discontinued their respective treatments with ipratropium bromide/salbutamol, levosalbutamol and salbutamol. They were discharged. Thereafter, all cardiac events resolved. Parlar-Chun R, et al. Descriptions and outcomes of cardiac evaluations in pediatric patients hospitalized for asthma. Journal of Asthma 57: 1195-1201, No. 11, Nov 2020. 803518435 Available from: URL: http://doi.org/10.1080/02770903.2019.1642353
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Reactions 5 Dec 2020 No. 1833
