Benzalkonium chloride and bronchoconstriction

“…9,10 There have been several case reports of adults as well as children with asthma in whom paradoxic bronchoconstriction developed after repeated doses of nebulized albuterol containing BAC. 11,12 Asmus and colleagues used a double-blind crossover study to investigate the airway effects of ethylenediamine tetraacetic acid (EDTA), with BAC and saline solution used as the positive and negative controls, and demon- strated that BAC caused clinically significant bronchoconstriction when inhaled in doses used in emergency treatment of acute asthma attack. 13 One controlled study has examined the effect of BAC on the bronchodilator response resulting from a single dose of albuterol nebulizer solution.…”

Section: Discussionmentioning

confidence: 99%

Inner-City Availability of Preservative-Containing Albuterol

Reznik

Sharif

Ozuah

2004

Clin Pediatr (Phila)

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Benzalkonium chloride (BAC) added to nebulized albuterol may induce bronchospasm. The objective of this study was to determine the availability of BAC-containing nebulized albuterol in the Bronx, New York pharmacies. A cross-sectional telephone survey of pharmacies was conducted. Overall, 158 (80%) pharmacies participated in the survey; 133 (84%) carried BAC-containing albuterol; 25 (16%) dispensed BAC-containing albuterol solution when presented with a prescription written for generic albuterol. Only 14 (9%) pharmacists had seen a prescription for nebulized albuterol where a physician specified "without BAC." Despite availability of BAC-free albuterol, pharmacies in the Bronx still carried and dispensed BAC-containing product.

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“…A number of case reports described paradoxical bronchospasm from albuterol solutions containing BAC, and one of them was associated with a respiratory arrest . Common to these reports was the claim that when the patient was switched to a preservative‐free product, there was a decrease in bronchospasm.…”

Section: Controlled Trials With Benzalkonium Chloridementioning

confidence: 99%

Benzalkonium Chloride: A Bronchoconstricting Preservative in Continuous Albuterol Nebulizer Solutions

2017

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For convenience, many pediatric hospitals are preparing solutions for continuous nebulized albuterol using the 0.5% 20-ml multidose albuterol dropper bottle. This product contains benzalkonium chloride (BAC) that, by itself, produces bronchospasm that is dose dependent and cumulative. The bronchoconstrictive effects of BAC are greater in patients with more severe airway obstruction and increased airway responsiveness. Use of BAC-containing albuterol during severe acute asthma exacerbations may antagonize the bronchodilator response to albuterol, prolong treatment, and increase the risk of albuterol-related systemic adverse effects. Such a deleterious effect of BAC is difficult to detect because some patients improve slowly or may even worsen during treatment. We recommend that only preservative-free albuterol products be used.

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Benzalkonium chloride and bronchoconstriction

Cited by 39 publications

References 16 publications

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Inner-City Availability of Preservative-Containing Albuterol

Benzalkonium Chloride: A Bronchoconstricting Preservative in Continuous Albuterol Nebulizer Solutions

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