TY - JOUR AU - Ayed, Khadija AU - Hadi Khalifa, Islam Latifa AU - Mokaddem, Salma AU - Ben Khamsa Jameleddine, Saloua PY - 2020/10/05 Y2 - 2024/03/28 TI - Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists JF - Drug Target Insights JA - dti VL - 14 IS - 1 SE - Short communication DO - 10.33393/dti.2020.2188 UR - https://journals.aboutscience.eu/index.php/dti/article/view/2188 SP - 12-15 AB - <p class="abstract"><strong>Introduction</strong>: Salbutamol and terbutaline are short-acting β<sub>2</sub> adrenergic agonists that produce bronchial smooth muscle relaxation and are widely used in obstructive pulmonary diseases. Nevertheless, their use has been the cause of a paradoxical bronchoconstriction, which is a rare and potentially serious adverse reaction. The aim of this study is to report a case of paradoxical bronchoconstriction caused by β<sub>2</sub> adrenergic agonists.</p><p class="abstract"><strong>Methods</strong>: This case is about a 50-year-old asthmatic patient who describes a history of repeated acute asthma attacks after salbutamol inhalation or terbutaline nebulization. A double-blind crossover study was performed over 3 days, in order to compare the effects of each bronchodilator. Forced expiratory volume in 1 second (FEV<sub>1</sub>), forced vital capacity (FVC), and maximal expiratory flow 25-75 (MEF25-75) were measured.</p><p class="abstract"><strong>Results</strong>: On the first day, a bronchoconstriction caused by deep and repeated inhalations was eliminated. On the second day, an airway obstruction was confirmed by a decrease in FEV<sub>1</sub> at 40% from baseline values after nebulization of a standard dose of terbutaline. On the third day, a spirometry was performed before and after nebulization of a standard dose of ipratropium bromide, and there were no significant changes in the spirometric parameters. Finally the patient was discharged with a written warning mentioning the danger of salbutamol and terbutaline use.</p><p class="abstract"><strong>Conclusion</strong>: Salbutamol and terbutaline are generally well-tolerated β<sub>2</sub> adrenergic agonists. Nevertheless, in rare cases, these substances can cause a paradoxical bronchoconstriction. Doctors must therefore remain vigilant about its side effect and possibly investigate each case.</p> ER -