Adverse Effects of Salbutamol

Cardiovascular Effects

The American Heart Association notes that taquicardia is the most frequent cardiovascular adverse effect, especially with systemic administration (nebulized or intravenous) compared to metered-dose inhalers 1, 2
The American College of Cardiology recommends caution when using salbutamol in patients with pre-existing cardiovascular disease, as it may cause ischemia in patients with coronary artery disease, with an average increase of 13 beats per minute in some studies 1, 2
The use of salbutamol has been associated with ventricular premature contractions, although severe ventricular arrhythmias are rare 1, 2
A case of takotsubo cardiomyopathy has been reported in association with repeated use of salbutamol inhaler, representing a potentially fatal cardiovascular complication 1, 2

The European Respiratory Society notes that short-acting beta-agonists are associated with a decrease in plasma potassium values, typically <1 mmol/L, with a mean decrease of 0.54 mmol/L in one study and 0.52 mmol/L in another 1, 2
The decrease in potassium levels is usually transient and does not require supplementation, although the clinical significance is not fully established 1, 2

The American Thoracic Society reports that severe bronchospasm has been reported after exposure to salbutamol inhaler and nebulized treatment, representing a potentially fatal paradoxical reaction 1, 2

The European Respiratory Journal notes that systemic administration (nebulized or intravenous) causes more cardiovascular and metabolic adverse effects than administration by metered-dose inhaler 4, 5
The use of systemic beta-agonists may have a tocolytic effect during labor 4, 5
In the context of pregnancy, systemic administration may cause maternal and fetal tachycardia, maternal hyperglycemia, and neonatal hypoglycemia 4, 5

The American Academy of Allergy, Asthma, and Immunology recommends that an increase in the need for rescue medication indicates inadequate control and requires immediate medical evaluation 6