The dose‐related hyper‐and‐hypokalaemic effects of salbutamol and its arrhythmogenic potential

W. J. Du Plooy*, L. Hay, C. P. Kahler, P. J. Schutte, H. D. Brandt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

The hypokalaemic effect of salbutamol after more than 30 min of administration has been well described. A hyper‐and‐hypokalaemic effect for adrenaline has been reported, but no such hyperkalaemic effect for salbutamol. The possible hyper‐and‐hypokalaemic effects of salbutamol with the concomitant potential for pro‐arrhythmia were assessed in the baboon (Papio ursinus). Male and femal baboons were anaesthetized with ketamine (15 mg kg−1) and maintained with 6% pentobarbitone as spontaneously breathing animals. Six baboons in each group received either 10, 100 or 500 μg kg−1 salbutamol i.v. Lead II of the ECG and femoral i.a. blood pressure were recorded continuously for 10 min. Arterial blood samples were collected at 0 min and then after 3 and 10 min of salbutamol administration. All the animals developed sinus tachycardia (above 200 beats min−1) within 30 s of each dose of salbutamol administration and the high heart rate persisted throughout the experiment. All the animals were hyperkalaemic after 3 min and hypokalaemic after 10 min for each dose of salbutamol. Left ventricular conduction defects were seen in 3 animals during the hyperkalaemic phase. No arrhythmia was seen during the hypokalaemic phase. Salbutamol has a transient hyperkalaemic and a more prolonged hypokalaemic effect in the baboon. The hypokalaemia could not be associated with arrhythmia although conduction defects were associated with the hyperkalaemia. Since salbutamol is used as a bronchodilator in asthmatic patients and to treat acute hyperkalaemia, it is suggested that caution should be exercised when using salbutamol in high doses to treat acute asthma especially during the first few minutes of administration. The finding of hyperkalaemia with salbutamol questions its use in the treatment of hyperkalaemia. 1994 British Pharmacological Society

Original languageEnglish
Pages (from-to)73-76
Number of pages4
JournalBritish Journal of Pharmacology
Volume111
Issue number1
DOIs
Publication statusPublished - Jan 1994

Keywords

  • Salbutamol
  • arrhythmia
  • asthma
  • hyperkalaemia
  • hypokalaemia

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