Rhabdomyolysis and Acute Renal Failure after Terbutaline Overdose

Abstract

A case of rhabdomyolysis-induced acute renal failure secondary to overdosage with the β₂-adrenoceptor agonist terbutaline is described. This is a previously undocumented association. We propose that the hyperkinetic effects of intense β-receptor stimulation may induce rhabdomyolysis.

Acute Weakness Syndromes in Critically Ill Patients—A Reappraisal

“…EMG performed in five patients supported a diagnosis of myopathy in two. Beta-adrenergic agonists and theophylline have also been associated with rhabdomyolysis 65,66 . Barret 67 reported two asthmatic patients with rhabdomyolysis but no weakness who had received steroids but no NMBAs.…”

Rhabdomyolysis in Acute Severe Asthma: A Case Report and Literature Review

“…Excessive use of beta sympathomimetic agents may cause agitation and tremors leading to rhabdomyolysis ( 11 ). Acute oral theophylline intoxication has also been reported to cause rhabdomyolysis (11). Finally cocaine use has been associated with both acute asthma and rhabdomyolysis.…”

Rhabdomyolysis and Acute Renal Failure following Methadone Abuse

“…In most cases limb compression associated with uncon scious state and secondary' ischemia is a criti cal factor in producing rhabdomyolysis [2], a direct toxic effect is likely in alcohol abuse [2,3] and rhabdomyolysis is probably related to increased demands on muscle in |5-agonist and amphetamine overdose [5], Rhabdo myolysis may induce renal damage second ary to tubular obstruction by myoglobin and results in acute renal failure in up to one third of the cases [I, 2], In our case rhabdomyolysis was con firmed by a hundredfold increase in the se rum creatine kinase level and myoglobinuria; acute renal failure was confirmed by anuria at admission and an increase in the serum crea tinine level. We found only one report of methadone abuse in association with rhabdo myolysis and acute renal failure [6], but this case suggests that methadone abuse, like that of other narcotics, may be the cause of non traumatic rhabdomyolysis and acute renal failure.…”