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Adrenergic bronchodilator overdose

 

Adrenergic bronchodilators are inhaled medicines that help open up the airways. They are used to treat asthma and chronic bronchitis. Adrenergic bronchodilator overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

In large amounts, these medicines can be poisonous:

  • Albuterol
  • Bitolterol
  • Ephedrine
  • Epinephrine
  • Isoetharine
  • Isoproterenol
  • Metaproterenol
  • Pirbuterol
  • Racepinephrine
  • Ritodrine
  • Terbutaline

Other bronchodilators may also be harmful when taken in large amounts.

Where Found

 

The substances listed above are found in medicines. Brand names are in parentheses:

  • Albuterol (Proventil, Ventolin)
  • Bitolterol (Tornalate)
  • Ephedrine (Ephed II)
  • Epinephrine (Adrenalin, AsthmaHaler, Bronitin Mist, Bronkaid Mist, Medihaler-Epi, Primatene Mist, EpiPen Auto-Injector, Sus-Phrine, Twinject)
  • Ethylnorepinephrine (Bronkephrine)
  • Isoetharine (Arm-a-Med Isoetharine, Bronkometer, Bronkosol, Dey-Dose Isoetharine, Dispos-a-Med Isoetharine, Dey-Lute Isoetharine)
  • Isoproterenol (Aerolone, Dey-Dose Isoproterenol, Dispos-a-Med Isoproterenol, Isuprel, Medihaler-Iso, Norisodrine Aerotrol, Vapo-Iso)
  • Metaproterenol (Alupent, Arm-a-Med Metaproterenol, Dey-Dose Metaproterenol, Dey-Lute Metaproterenol, Metaprel)
  • Pirbuterol (Maxair)
  • Racepinephrine (AsthmaNefrin, Dey-Dose Racepinephrine, Vaponefrin)
  • Terbutaline (Breathaire, Brethine, Bricanyl)

Other brands of bronchodilators may also be available.

 

Symptoms

 

Below are symptoms of an adrenergic bronchodilator overdose in different parts of the body.

Airways and lungs

  • Difficulty breathing
  • Shallow breathing
  • Rapid breathing
  • No breathing

Bladder and kidneys

  • No urine output

Eyes, ears, nose, and throat

  • Blurred vision
  • Dilated pupils
  • Burning throat

Heart and blood vessels

  • High blood pressure, then low blood pressure
  • Rapid heartbeat

Nervous system

  • Chills
  • Coma
  • Convulsions
  • Fever
  • Irritability
  • Nervousness
  • Tingling of hands and feet
  • Tremor

Skin

  • Blue lips and fingernails

Stomach and intestines

  • Nausea
  • Vomiting

 

Home Care

 

Seek medical help right away.

 

Before Calling Emergency

 

Have this information ready:

  • Person's age, weight, and condition
  • Name of the product (ingredients and strength, if known)
  • Time it was swallowed
  • Amount swallowed

 

Poison Control

 

Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

 

What to Expect at the Emergency Room

 

Take the container with you to the hospital, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. The person may receive:

  • Activated charcoal
  • Blood and urine tests
  • Breathing support, including oxygen
  • Chest x-ray
  • EKG (electrocardiogram, or heart tracing)
  • Intravenous (through a vein) fluids
  • Laxative
  • Medicines to treat symptoms
  • Tube placed down the nose and into the stomach (gastric lavage)

Blood tests may show changes in blood sugar and low potassium levels.

 

Outlook (Prognosis)

 

Survival past 24 hours is usually a good sign that the person will recover. People who have seizures, breathing difficulties, and heart rhythm disturbances may have the most serious problems after an overdose.

 

 

References

Akhtar J, Rittenberger JC. Clinical neurotoxicology. In: Shannon MW, Borron SW, Burns MJ. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 10.

Rowak RM, Tokarski GF. Asthma. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 73.

Thomas SHL, White J. Poisoning. In: Walker BR, Colledge NR, Ralston SH, Penman ID, eds. Davidson's Principles and Practice of Medicine. 22nd ed. Elsevier Limited; 2014:chap 9.

 

        A Closer Look

         

          Self Care

           

            Tests for Adrenergic bronchodilator overdose

             

               

              Review Date: 7/14/2015

              Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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