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Adrenergic bronchodilator overdose

Definition

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 article is for information only. 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 control 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 (AccuNeb, ProAir, Proventil, Ventolin Vospire)
• Ephedrine
• Epinephrine (Adrenalin, AsthmaHaler, EpiPen Auto-Injector)
• Isoproterenol
• Metaproterenol
• Terbutaline

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

• Feeling breathless or short of breath
• 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

• Chest pain
• High blood pressure, then low blood pressure
• Rapid heartbeat
• Shock (extremely low blood pressure)

NERVOUS SYSTEM

• Chills
• Coma
• Convulsions (seizures)
• Fever
• Irritability
• Nervousness
• Tingling of hands and feet
• Tremor
• Weakness

SKIN

• Blue lips and fingernails

STOMACH AND INTESTINES

• Nausea and vomiting

Home Care

Seek medical help right away. Call 911 or your local emergency services number.

Before Calling Emergency

Have this information ready:

• The 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 control 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 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.

Your health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure.

If the medicine was swallowed, tests may include:

• Blood and urine tests
• Chest x-ray
• CT scan (advanced imaging) of the brain for neurologic symptoms
• Electrocardiogram (ECG)

Treatment may include:

• Activated charcoal
• Breathing support, including oxygen, through the mouth into the lungs, and breathing machine (ventilator)
• Fluids through a vein (IV)
• Laxative
• Medicines to treat symptoms

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

Aronson JK. Adrenaline (epinephrine). In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:86-94.

Aronson JK. Salmeterol. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:294-301.

Aronson JK. Ephedra, ephedrine, and pseudoephedrine. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:65-75.

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