The effects of salbutamol on some metabolic and endocrine patterns of diabetic subjects

Torella, Roberto; Grandillo, F; Giugliano, Dario; Improta, L; Varricchio, Maria Teresa

doi:10.1016/s0031-6989(80)80055-5

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Most previous studies used systemic routes of administration 4-6 of adrenergic agents, or larger doses than the recommended ones by the inhaled route. 9,10 Most of these studies showed an increase in blood glucose [4][5][6]9 after administration of these drugs. Interestingly, the study by Bateman et al, 10 done in asthmatics, showed that albuterol 5 mg (double the recommended dose) did not raise blood glucose in asthmatics patients, while another study in healthy subjects showed a significant increase in glucose with the same dose.…”

Section: Discussionmentioning

confidence: 99%

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Effect of nebulized albuterol on blood glucose in patients with diabetes mellitus with and without cystic fibrosis

König

Goldstein

Poehlmann

et al. 2005

Pediatric Pulmonology

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Over 90% of cystic fibrosis (CF) patients are treated with bronchodilators, and 6% have diabetes. Some with asthma also have diabetes, and most are treated with bronchodilators. Systemic administration of adrenergic agents can cause increases in blood glucose, but the effect of inhaled agents is unclear. A double-blind study was performed on 10 patients with type 1 diabetes mellitus (DM) without CF (3 male, 7 female, mean age 25.5 years) and 9 patients with insulin-dependent CF-related diabetes (CFRD) (8 male, 1 female, mean age 21.9 years). On 2 separate days before 9 AM fasting and the morning dose of insulin, 2.5 mg of albuterol or nebulized placebo were given. Blood glucose was measured by finger stick with a glucose reflectance meter before and 15, 30, 45, and 60 min after treatment. No significant changes from baseline or differences between placebo and albuterol occurred in either group. The mean maximum increase from baseline in DM was 20 mg/dl on placebo, and 38 mg/dl on albuterol; in the CFRD, the respective changes were 7 and 7 mg/dl. Two DM patients had a > 50 mg/dl increase on albuterol vs. placebo; no CFRD patients had differences of such magnitude. DM patients had greater increases from baseline than CFRD patients on placebo and albuterol. Differences reached statistical significance at 30 and 45 min on placebo, and 45 min on albuterol. Albuterol 2.5 mg by nebulizer causes no clinically significant increases in blood glucose in DM or CFRD patients. Diabetes patients without CF have a significantly greater increase of glucose with time (placebo or albuterol) than CFRD patients.

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Section: Discussionmentioning

confidence: 99%

“…Adrenergic agents, given by the oral 4 or intravenous route, 5,6 were shown to increase the blood glucose level in normal subjects and patients with diabetes.…”

Section: Introductionmentioning

confidence: 99%

Effect of nebulized albuterol on blood glucose in patients with diabetes mellitus with and without cystic fibrosis

König

Goldstein

Poehlmann

et al. 2005

Pediatric Pulmonology

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show abstract

“…Hypokalemia and increased serum levels of insulin, glucose, pyruvate, free fatty acids, and lactate have been found in patients receiving high doses of salbutamol, regardless of the route of administration [ 67 ]. Salbutamol causes hypokalemia primarily through β2-stimulation of the Na + /K + -ATPase pump in skeletal muscle, which shifts potassium intracellularly.…”

Section: Data Safety Of Short-acting Bronchodilator Administration In...mentioning

confidence: 99%

Critical reappraisal of short-acting bronchodilators for pediatric respiratory diseases

Licari,

Manti,

Mastellone

et al. 2024

Ital J Pediatr

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Short-acting bronchodilators are a class of medications commonly used to treat asthma, chronic obstructive pulmonary disease, and other respiratory conditions. The use of these medications has evolved over time as we have gained a better understanding of their effectiveness and safety in the pediatric population. This comprehensive review synthesizes the current understanding of short-acting β2-agonists and short-acting anticholinergics in children. It addresses indications, contraindications, safety considerations, and highlights areas where further research is needed to guide the most effective use of short-acting bronchodilators.

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Albuterol: An Adrenergic Agent for Use in the Treatment of Asthma Pharmacology, Pharmacokinetics and Clinical Use

Ahrens

Smith

1984

Pharmacotherapy

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Albuterol is a long-acting beta 2-adrenergic receptor-selective drug that relaxes airway smooth muscle. It is currently available in the United States in oral and metered-dose inhaler forms. Nebulizer solutions and parenteral preparations are likely to be marketed here in the future. The chemical modifications that make albuterol beta 2-selective also promote oral bioavailability and increased duration of action by decreasing sensitivity to degradative enzymes. Albuterol can also produce undesirable dose-related effects: metabolic effects including decreased levels of plasma potassium, phosphate, calcium and magnesium; increased levels of plasma glucose, insulin, renin, lactate and ketones; peripheral vasodilation and perhaps some direct cardiac stimulation resulting in decreased systemic and pulmonary vascular resistance, increased pulse pressure and tachycardia; and skeletal muscle tremor. These side effects are most common with parenteral administration and much less prominent with aerosol administration, which yields lower systemic concentrations. Limited pharmacokinetic data suggest a long distribution phase, a terminal half-life of 3-8 hours, and 10-20% oral bioavailability. Aerosolization of albuterol or a similar agent with a compressed-air nebulizer appears to be best first-line management of the patient with acute dyspneic asthma, but appropriate preparations for this kind of therapy are currently missing from the United States market. Intravenous albuterol has also been employed in acutely dyspneic patients, but produces more side effects than carefully administered intravenous theophylline, is impaired by lack of sufficient pharmacokinetic information to guide dosing, and is of uncertain efficacy in the asthmatic with respiratory failure. However, it appears to lack the potentially life-threatening side effects that can result when theophylline is used carelessly . In the ambulatory patient, aerosolized albuterol (or a similar agent) administered by metered-dose inhaler is an excellent agent for treatment as needed and/or for prevention of acute bronchospasm triggered by exercise or other predictable cause. Advantages include a high degree of efficacy, rapid onset and long duration of effect, and minimal side effects. Regularly scheduled administration of albuterol by metered-dose inhaler is a widely used and effective maintenance medication for patients requiring long-term prophylactic therapy. However comparisons of the ability of this regimen and the other common maintenance regimens (cromolyn and theophylline) to control chronic symptoms of asthma are needed.

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The effects of salbutamol on some metabolic and endocrine patterns of diabetic subjects

Cited by 5 publications

References 12 publications

Effect of nebulized albuterol on blood glucose in patients with diabetes mellitus with and without cystic fibrosis

Effect of nebulized albuterol on blood glucose in patients with diabetes mellitus with and without cystic fibrosis

Critical reappraisal of short-acting bronchodilators for pediatric respiratory diseases

Albuterol: An Adrenergic Agent for Use in the Treatment of Asthma Pharmacology, Pharmacokinetics and Clinical Use

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