Forensic aspects of salbutamol overdose – doping, abuse, and suicide
DOI:
https://doi.org/10.15584/ejcem.2024.4.2Keywords:
abuse, doping, forensic toxicology, overdose, salbutamol, suicideAbstract
Introduction and aim. Salbutamol is a popular drug used in respiratory diseases. With the increasing prevalence of the use of this substance for therapeutic purposes and its availability on the market, the frequency of its use for other purposes has also risen due to its effects outside the respiratory system. The aim of the study was to investigate the medico-legal aspects of salbutamol.
Material and methods. Medical literature databases such as PubMed, Scopus, Web of Science and Google Scholar were searched. The search was carried out in accordance with the specified purpose of the keyword research using Boolean operators.
Analysis of the literature. In sports, the use of salbutamol is strictly regulated by anti-doping regulations. Recreational substance abuse and accidental overdoses, mainly among children and the elderly, are also important. Rare cases of suicide attempts associated with the use of salbutamol have also been reported.
Conclusion. Salbutamol overdoses are usually not life threatening. However, one should remember about the possibility of accidental overdose, especially among the elderly and children taking the drug chronically. Currently, the use of salbutamol for recreational purposes is rare. In sports, the status of salbutamol use, especially among athletes who do not require its use for therapeutic reasons, is still a controversial issue.
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Brittain RT, Farmer JB, Jack D, Martin LE, Simpson WT. α-[(t-Butylamino)methyl]-4-hydroxy-m-xylene-α1, α3-diol (AH.3365): a Selective β-Adrenergic Stimulant. Nature. 1968;219(5156):862-863. doi: 10.1038/219862a0
Cullum VA, Farmer JB, Jack D, Levy GP. Salbutamol: a new, selective β‐adrenoceptive receptor stimulant. Br J Pharmacol. 1969;35(1):141-151. doi: 10.1111/j.1476-5381.1969.tb07975.x
Waller D, Sampson AP. Medical Pharmacology & Therapeutics. Fifth edition. Elsevier; 2018.
Libretto SE. A review of the toxicology of salbutamol (albuterol). Arch Toxicol. 1994;68(4):213-216. doi: 10.1007/s002040050059
Marques L, Vale N. Salbutamol in the Management of Asthma: A Review. Int J Mol Sci. 2022;23(22):14207. doi: 10.3390/ijms232214207
Hatipoglu US, Aboussouan LS. Treating and preventing acute exacerbations of COPD. Cleve Clin J Med. 2016;83(4):289-300. doi: 10.3949/ccjm.83a.14188
Brodde OE, Schüler S, Kretsch R, et al. Regional Distribution of β-Adrenoceptors in the Human Heart: Coexistence of Functional β1 and β2-Adrenoceptors in Both Atria and Ventricles in Severe Congestive Cardiomyopathy. J Cardiovasc Pharmacol. 1986;8(6):1235-1242. doi: 10.1097/00005344-198611000-00021
Moore LE, Kapoor K, Byers BW, et al. Acute effects of salbutamol on systemic vascular function in people with asthma. Respir Med. 2019;155:133-140. doi: 10.1016/j.rmed.2019.07.018
Filipský T, Zatloukalová L, Mladěnka P, Hrdina R. Acute initial haemodynamic changes in a rat isoprenaline model of cardiotoxicity. Hum Exp Toxicol. 2012;31(8):830-843. doi: 10.1177/0960327112438927
Product monograph including patient medication information prventolin. Respirator Solution, salbutamol sulfate solution Solution, 5 mg/mL, for Oral Inhalation. https://ca.gsk.com/media/6225/ventolin-nebules.pdf. Accessed March 15, 2024.
Charakterystyka produktu leczniczego salbutamol hasco, 2 mg/5 ml, syrup. https://rejestrymedyczne.ezdrowie.gov.pl/api/rpl/medicinal-products/5948/characteristic. Accessed March 15, 2024.
Product monograph apo-salvent Salbutamol 2 or 4mg tablets. https://pdf.hres.ca/dpd_pm/00023952.pdf. Accessed March 15, 2024.
Charakterystyka Produktu Leczniczego Salbutamol WZF, 2 or 4mg tablets. http://chpl.com.pl/data_files/2012-09-10_salbutamol_wzf_tabl_chpl_final_reer_2012.pdf. Accessed March 15, 2024.
Charakterystyka produktu leczniczego Buventol Easyhaler, salbutamol sulfate dry powder, 100 mcg. http://chpl.com.pl/data_files/BUVENTOLEasyhaler_proszek_100mcg.pdf. Accessed March 15, 2024.
Product monograph prventolin diskus salbutamol sulfate dry powder for inhalation 200 mcg. https://ca.gsk.com/media/6220/ventolin-diskus.pdf. Accessed March 15, 2024.
Product monograph prventolin HFA salbutamol pressurised inhalation, 100 mcg. https://ca.gsk.com/media/6222/ventolin-hfa.pdf. Accessed March 15, 2024.
Charakterystyka produktu leczniczego salbutamol WZF, 0,5 mg/ml, solution for injection. http://chpl.com.pl/data_files/2012-09-10_salbutamol_wzf_0,5_mg_ml__inj_chpl_final_rere_2012.pdf. Accessed March 15, 2024.
Product monograph prventolin I.V. infusion solution salbutamol sulfate for injection 1000 mcg/mL. Published November 27, 2023. https://ca.gsk.com/media/6224/ventolin-iv.pdf. Accessed March 15, 2024.
Straat ME, Hoekx CA, Van Velden FHP, et al. Stimulation of the beta-2-adrenergic receptor with salbutamol activates human brown adipose tissue. Cell Rep Med. 2023;4(2):100942. doi: 10.1016/j.xcrm.2023.100942
Cero C, Lea HJ, Zhu KY, Shamsi F, Tseng YH, Cypess AM. β3-Adrenergic receptors regulate human brown/beige adipocyte lipolysis and thermogenesis. JCI Insight. 2021;6(11):e139160. doi: 10.1172/jci.insight.139160
Cypess AM, Weiner LS, Roberts-Toler C, et al. Activation of Human Brown Adipose Tissue by a β3-Adrenergic Receptor Agonist. Cell Metab. 2015;21(1):33-38. doi: 10.1016/j.cmet.2014.12.009
Lowell BB, Flier JS. BROWN ADIPOSE TISSUE, β3-ADRENERGIC RECEPTORS, AND OBESITY. Annu Rev Med. 1997;48(1):307-316. doi: 10.1146/annurev.med.48.1.307
Ayed K, Hadi Khalifa IL, Mokaddem S, Ben Khamsa Jameleddine S. Paradoxical bronchoconstriction caused by β2-adrenoceptor agonists. Drug Target Insights. 2020;14(1):12-15. doi: 10.33393/dti.2020.2188
Marques L, Vale N. Prediction of CYP-Mediated Drug Interaction Using Physiologically Based Pharmacokinetic Modeling: A Case Study of Salbutamol and Fluvoxamine. Pharmaceutics. 2023;15(6):1586. doi: 10.3390/pharmaceutics15061586
Lee M. The history of Ephedra (ma-huang). J R Coll Physicians Edinb. 2011;41(1):78-84. doi: 10.4997/JRCPE.2011.116
Ahlquist RP. Development of the concept of alpha and beta adrenotropic receptors. Ann N Y Acad Sci. 1967;139(3):549-552. doi: 10.1111/j.1749-6632.1967.tb41228.x
Strosberg AD. Structure, function, and regulation of adrenergic receptors. Protein Sci. 1993;2(8):1198-1209. doi: 10.1002/pro.5560020802
Inman WHW, Adelstein AM. Rise and fall of asthma mortality in england and wales in relation to use of pressurised aerosols. Lancet. 1969;294(7615):279-285. doi: 10.1016/S0140-6736(69)90051-8
Speizer FE, Doll R, Heaf P, Strang LB. Investigation into use of drugs preceding death from asthma. BMJ. 1968;1(5588):339-343. doi: 10.1136/bmj.1.5588.339
Dhand R. Nebulizers that use a vibrating mesh or plate with multiple apertures to generate aerosol. Respir Care. 2002;47(12):1406-1416; discussion 1416-1418.
Skaria S, Smaldone GC. Omron NE U22: Comparison Between Vibrating Mesh and Jet Nebulizer. J Aerosol Med Pulm Drug Deliv. 2010;23(3):173-180. doi: 10.1089/jamp.2010.0817
Martin AR, Finlay WH. Nebulizers for drug delivery to the lungs. Expert Opin Drug Deliv. 2015;12(6):889-900. doi: 10.1517/17425247.2015.995087
Barjaktarevic IZ, Milstone AP. Nebulized Therapies in COPD: Past, Present, and the Future. Int J Chron Obstruct Pulmon Dis. 2020;15:1665-1677. doi: 10.2147/COPD.S252435
Payares Salamanca L, Contreras Arrieta S, Florez García V, Barrios Sanjuanelo A, Stand Niño I, Rodriguez Martinez CE. Metered dose inhalers versus nebulization for the delivery of albuterol for acute exacerbations of wheezing or asthma in children: A systematic review with meta analysis. Pediatr Pulmonol. 2020;55(12):3268-3278. doi: 10.1002/ppul.25077
Gillette C, Rockich-Winston N, Kuhn JA, Flesher S, Shepherd M. Inhaler Technique in Children With Asthma: A Systematic Review. Acad Pediatr. 2016;16(7):605-615. doi: 10.1016/j.acap.2016.04.006
Reznik M, Silver EJ, Cao Y. Evaluation of MDI-spacer utilization and technique in caregivers of urban minority children with persistent asthma. J Asthma. 2014;51(2):149-154. doi: 10.3109/02770903.2013.854379
Gaikwad SS, Pathare SR, More MA, et al. Dry Powder Inhaler with the technical and practical obstacles, and forthcoming platform strategies. J Controlled Release. 2023;355:292-311. doi: 10.1016/j.jconrel.2023.01.083
Ruzycki CA, Tavernini S, Martin AR, Finlay WH. Characterization of dry powder inhaler performance through experimental methods. Adv Drug Deliv Rev. 2022;189:114518. doi: 10.1016/j.addr.2022.114518
Shetty N, Cipolla D, Park H, Zhou QT. Physical stability of dry powder inhaler formulations. Expert Opin Drug Deliv. 2020;17(1):77-96. doi: 10.1080/17425247.2020.1702643
Louridas G, Kakoura M, Galanis N, Patakas D, Kastritsi K. Bronchodilatory Effect of Inhaled versus Oral Salbutamol in Bronchial Asthma. Respiration. 1983;44(6):439-443. doi: 10.1159/000194582
Evans ME, Paterson JW, Richards AJ, Walker SR. Pharmacokinetics of inhaled salbutamol in asthmatic patients. Br J Pharmacol. 1971;43(2):466P-467P.
Le Roux AM, Kotze D, Wium CA, Van Jaarsveld PP, Joubert JR. Inhaled and Oral Salbutamol: How Effective in the Prophylaxis of Asthma? Respiration. 1991;58(3-4):192-197. doi: 10.1159/000195925
Skoner DP. Pharmacokinetics, pharmacodynamics, and the delivery of pediatric bronchodilator therapy. J Allergy Clin Immunol. 2000;106(3):S158-S164. doi: 10.1067/mai.2000.109422
Kruizinga MD, Birkhoff WAJ, Van Esdonk MJ, et al. Pharmacokinetics of intravenous and inhaled salbutamol and tobramycin: An exploratory study to investigate the potential of exhaled breath condensate as a matrix for pharmacokinetic analysis. Br J Clin Pharmacol. 2020;86(1):175-181. doi: 10.1111/bcp.14156
Joyce KB, Jones AE, Scott RJ, Biddlecombe RA, Pleasance S. Determination of the enantiomers of salbutamol and its 4-O-sulphate metabolites in biological matrices by chiral liquid chromatography tandem mass spectrometry. Rapid Commun Mass Spectrom. 1998;12(23):1899-1910. doi: 10.1002/(SICI)1097-0231(19981215)12:23<1899::AID-RCM417>3.0.CO;2-I
Sjöswärd KN, Josefsson M, Ahlner J, Andersson RGG, Schmekel B. Metabolism of Salbutamol Differs between Asthmatic Patients and Healthy Volunteers. Pharmacol Toxicol. 2003;92(1):27-32. doi: 10.1034/j.1600-0773.2003.920105.x
Adler A, Uziel Y, Mei-Zahav M, Horowitz I. Formoterol induces tolerance to the bronchodilating effect of Salbutamol following methacholine-provocation test in asthmatic children. Pulm Pharmacol Ther. 2006;19(4):281-285. doi: 10.1016/j.pupt.2005.07.005
Minton NA, Baird AR, Henry JA. Modulation of the effects of salbutamol by propranolol and atenolol. Eur J Clin Pharmacol. 1989;36(5):449-453. doi: 10.1007/BF00558068
Anavekar SN, Barter C, Adam WR, Doyle AE. A Double-Blind Comparison of Verapamil and Labetalol in Hypertensive Patients with Coexisting Chronic Obstructive Airways Disease: J Cardiovasc Pharmacol. 1982;4(3):S378. doi: 10.1097/00005344-198200433-00022
Jabbal S, Anderson W, Short P, Morrison A, Manoharan A, Lipworth BJ. Cardiopulmonary interactions with beta-blockers and inhaled therapy in COPD. QJM Int J Med. 2017;110(12):785-792. doi: 10.1093/qjmed/hcx155
Thomas P, Pugsley JA, Stewart JH. Theophylline and Salbutamol Improve Pulmonary Function in Patients with Irreversible Chronic Obstructive Pulmonary Disease. Chest. 1992;101(1):160-165. doi: 10.1378/chest.101.1.160
Barclay J, Whiting B, Meredith P, Addis G. Theophylline‐salbutamol interaction: bronchodilator response to salbutamol at maximally effective plasma theophylline concentrations. Br J Clin Pharmacol. 1981;11(2):203-208. doi: 10.1111/j.1365-2125.1981.tb01125.x
Dawson KP, Fergusson DM. Effects of oral theophylline and oral salbutamol in the treatment of asthma. Arch Dis Child. 1982;57(9):674-676. doi: 10.1136/adc.57.9.674
Eidelman DH, Sami MH, McGregor M, Cosio MG. Combination of Theophylline and Salbutamol for Arrhythmias in Severe COPD. Chest. 1987;91(6):808-812. doi: 10.1378/chest.91.6.808
Odhar HA. Salbutamol May Inhibit Monoamine Oxidase B (MAO-B) Enzyme: A Computational Study. Open Science Framework; 2022. doi: 10.31219/osf.io/c83zv
Odhar H.A H. Molecular docking analysis and dynamics simulation of salbutamol with the monoamine oxidase B (MAO-B) enzyme. Bioinformation. 2022;18(3):304-309. doi: 10.6026/97320630018304
Riederer P, Lachenmayer L, Laux G. Clinical Applications of MAO-Inhibitors. Curr Med Chem. 2004;11(15):2033-2043. doi: 10.2174/0929867043364775
Ajimura CM, Jagan N, Morrow LE, Malesker MA. Drug Interactions With Oral Inhaled Medications. J Pharm Technol. 2018;34(6):273-280. doi: 10.1177/8755122518788809
Edner M, Jogestrand T. Oral salbutamol decreases serum digoxin concentration. Eur J Clin Pharmacol. 1990;38(2). doi: 10.1007/BF00265984
Lei Y, Li X, Akash MSH, et al. Development of analytical method for ultrasensitive detection of salbutamol utilizing DNA labeled-immunoprobe. J Pharm Biomed Anal. 2015;107:204-208. doi: 10.1016/j.jpba.2014.12.027
Pleadin J, Vulic A, Persi N, Terzic S, Andrisic M, Zarkovic I. Rapid Immunoassay Method for the Determination of Clenbuterol and Salbutamol in Blood. J Anal Toxicol. 2013;37(4):241-245. doi: 10.1093/jat/bkt017
Wang Z, Zhou Q, Guo Y, et al. Rapid Detection of Ractopamine and Salbutamol in Swine Urine by Immunochromatography Based on Selenium Nanoparticles. Int J Nanomedicine. 2021;16:2059-2070. doi: 10.2147/IJN.S292648
Goyal RN, Oyama M, Singh SP. Fast determination of salbutamol, abused by athletes for doping, in pharmaceuticals and human biological fluids by square wave voltammetry. J Electroanal Chem. 2007;611(1-2):140-148. doi: 10.1016/j.jelechem.2007.08.014
Cordell RL, Valkenburg TSE, Pandya HC, Hawcutt DB, Semple MG, Monks PS. Quantitation of salbutamol using micro-volume blood sampling – applications to exacerbations of pediatric asthma. J Asthma. 2018;55(11):1205-1213. doi: 10.1080/02770903.2017.1402341
He H, Sun T, Liu W, et al. Highly sensitive detection of salbutamol by ALP-mediated plasmonic ELISA based on controlled growth of AgNPs. Microchem J. 2020;156:104804. doi: 10.1016/j.microc.2020.104804
Liu Z, Zhang B, Sun J, et al. Highly efficient detection of salbutamol in environmental water samples by an enzyme immunoassay. Sci Total Environ. 2018;613-614:861-865. doi: 10.1016/j.scitotenv.2017.08.324
Zhang D, Teng Y, Chen K, et al. Determination of salbutamol in human plasma and urine using liquid chromatography coupled to tandem mass spectrometry and its pharmacokinetic study. Biomed Chromatogr. 2012;26(10):1176-1182. doi: 10.1002/bmc.2675
Eenoo PV, Delbeke FT. Detection of inhaled salbutamol in equine urine by ELISA and GC/MS 2. Biomed Chromatogr. 2002;16(8):513-516. doi: 10.1002/bmc.194
Santos AM, Wong A, Fatibello-Filho O. Simultaneous determination of salbutamol and propranolol in biological fluid samples using an electrochemical sensor based on functionalized-graphene, ionic liquid and silver nanoparticles. J Electroanal Chem. 2018;824:1-8. doi: 10.1016/j.jelechem.2018.07.018
Ventura R, Ramírez R, Monfort N, Segura J. Ultraperformance liquid chromatography tandem mass spectrometric method for direct quantification of salbutamol in urine samples in doping control. J Pharm Biomed Anal. 2009;50(5):886-890. doi: 10.1016/j.jpba.2009.06.009
Hostrup M, Kalsen A, Auchenberg M, et al. Urine concentrations of oral salbutamol in samples collected after intense exercise in endurance athletes. Drug Test Anal. 2014;6(6):528-532. doi: 10.1002/dta.1568
Sheu SY, Lei YC, Tai YT, Chang TH, Kuo TF. Screening of salbutamol residues in swine meat and animal feed by an enzyme immunoassay in Taiwan. Anal Chim Acta. 2009;654(2):148-153. doi: 10.1016/j.aca.2009.09.026
Sjöswärd KN, Josefsson M, Ahlner J, Andersson RG, Schmekel B. Metabolism of salbutamol differs between asthmatic patients and healthy volunteers. Pharmacol Toxicol. 2003;92(1):27-32.
Fitch KD. The enigma of inhaled salbutamol and sport: unresolved after 45 years: Enigma of inhaled salbutamol and sport. Drug Test Anal. 2017;9(7):977-982. doi: 10.1002/dta.2184
Heuberger JAAC, Cohen AF. Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects. Sports Med. 2019;49(4):525-539. doi: 10.1007/s40279-018-1014-1
Molis MA, Molis WE. Exercise-Induced Bronchospasm. Sports Health Multidiscip Approach. 2010;2(4):311-317. doi: 10.1177/1941738110373735
Pigakis KM, Stavrou VT, Pantazopoulos I, Daniil Z, Kontopodi AK, Gourgoulianis K. Exercise-Induced Bronchospasm in Elite Athletes. Cureus. 2022;14(1):e20898. doi: 10.7759/cureus.20898
World anti-doping code. International standard. Prohibited list 2023. https://www.wada-ama.org/sites/default/files/2023-05/2023list_en_final_9_september_2022.pdf. Accessed March 20, 2024.
Pillard F, Lavit M, Cances VL, et al. Medical and pharmacological approach to adjust the salbutamol anti-doping policy in athletes. Respir Res. 2015;16(1):155. doi: 10.1186/s12931-015-0315-2
Heuberger JAAC, Van Dijkman SC, Cohen AF. Futility of current urine salbutamol doping control: Salbutamol doping control. Br J Clin Pharmacol. 2018;84(8):1830-1838. doi: 10.1111/bcp.13619
Courlet P, Buclin T, Biollaz J, Mazzoni I, Rabin O, Guidi M. Model based meta analysis of salbutamol pharmacokinetics and practical implications for doping control. CPT Pharmacomet Syst Pharmacol. 2022;11(4):469-481. doi: 10.1002/psp4.12773
Sporer BC, Sheel AW, Taunton J, Rupert JL, McKenzie DC. Inhaled Salbutamol and Doping Control: Effects of Dose on Urine Concentrations. Clin J Sport Med. 2008;18(3):282-285. doi: 10.1097/JSM.0b013e3181705c8c
Von Bueren AO, Ma R, Schlumpf M, Lichtensteiger W. Salbutamol exhibits androgenic activity in vitro. Br J Sports Med. 2007;41(12):874-878. doi: 10.1136/bjsm.2007.035162
Decorte N, Bachasson D, Guinot M, et al. Effect of Salbutamol on Neuromuscular Function in Endurance Athletes. Med Sci Sports Exerc. 2013;45(10):1925-1932. doi: 10.1249/MSS.0b013e3182951d2d
Martineau L, Horan MA, Rothwell NJ, Little RA. Salbutamol, a β 2-adrenoceptor agonist, increases skeletal muscle strength in young men. Clin Sci. 1992;83(5):615-621. doi: 10.1042/cs0830615
Riiser A, Stensrud T, Stang J, Andersen LB. Can β2-agonists have an ergogenic effect on strength, sprint or power performance? Systematic review and meta-analysis of RCTs. Br J Sports Med. 2020;54(22):1351-1359. doi: 10.1136/bjsports-2019-100708
Pluim BM, De Hon O, Staal JB, et al. β2-Agonists and Physical Performance: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports Med. 2011;41(1):39-57. doi: 10.2165/11537540-000000000-00000
Starkey ES, Mulla H, Sammons HM, Pandya HC. Intravenous salbutamol for childhood asthma: evidence-based medicine? Arch Dis Child. 2014;99(9):873-877. doi: 10.1136/archdischild-2013-304467
Schulz M, Iwersen-Bergmann S, Andresen H, Schmoldt A. Therapeutic and toxic blood concentrations of nearly 1,000 drugs and other xenobiotics. Crit Care. 2012;16(4):R136. doi: 10.1186/cc11441
Rakhmanina NY, Kearns GL, Farrar HC. Hypokalemia in an asthmatic child from abuse of albuterol metered dose inhaler: Pediatr Emerg Care. 1998;14(2):145-147. doi: 10.1097/00006565-199804000-00015
Misal G, Ghatage P, Kothari R, Mhaske S. A Case of Salbutamol Poisoning with Hypoglycemia. VIMS Health Sci J. 2018;5(1):38-39.
Yilmaz Hl, Kucukosmanoglu O, Hennes H, Celik T. Salbutamol intoxication: is salbutamol a drug-inducing fever? a case report and treatment strategy. Eur J Emerg Med. 2002;9(2). https://journals.lww.com/euro-emergencymed/fulltext/2002/06000/salbutamol_intoxication__is_salbutamol_a.16.aspx
Zheng B, Yadav K. Acute salbutamol toxicity in the emergency department: A case report. World J Emerg Med. 2021;12(1):73. doi: 10.5847/wjem.j.1920-8642.2021.01.012
Tomar RPS, Vasudevan R. Metabolic acidosis due to inhaled salbutamol toxicity: A hazardous side effect complicating management of suspected cases of acute severe asthma. Med J Armed Forces India. 2012;68(3):242-244. doi: 10.1016/j.mjafi.2011.10.002
Glatstein MM, Rimon A, Koren L, Marom R, Danino D, Scolnik D. Unintentional Oral Beta Agonist Overdose: Case Report and Review of the Literature. Am J Ther. 2013;20(3):311-314. doi: 10.1097/MJT.0b013e3182002f2d
Calabro MP, De Luca FL, Gitto E, Oreto G. Salbutamol-Induced Narrow QRS Tachycardia: What Is the Mechanism? J Cardiovasc Electrophysiol. 2006;17(7):792-793. doi: 10.1111/j.1540-8167.2006.00481.x
Pratt HF. Abuse of salbutamol inhalers in young people. Clin Exp Allergy. 1982;12(2):203-208. doi: 10.1111/j.1365-2222.1982.tb01640.x
Thompson PJ, Dhillon P, Cole P. Addiction to aerosol treatment: the asthmatic alternative to glue sniffing. BMJ. 1983;287(6404):1515-1516. doi: 10.1136/bmj.287.6404.1515-a
Wills BK, Kwan C, Bailey M, Johnson L, Allan N. Recalcitrant Supraventricular Tachycardia: Occult Albuterol Toxicity Due to a Factitious Disorder. J Emerg Med. 2015;49(4):436-438. doi: 10.1016/j.jemermed.2015.05.007
Chen C, Ray U, Jacobson G, Smillie M, Jordan N, Yu R. Biochemical munchausen’s - a “baffling” case of recurrent hypokalemia and lactic acidosis - secondary to surreptitious salbutamol abuse in a 36-year-old female. Case Rep Intern Med. 2016;3(3):17. doi: 10.5430/crim.v3n3p17
Aliaga CA, Arizon LFD, Bermúdez RM, Castán JAB, Santandreu AV. Severe hypokalemia secondary to abuse of β-adrenergic agonists in a pediatric patient: Case report. Braz J Nephrol. 2020;42(2):250-253. doi: 10.1590/2175-8239-jbn-2019-0020
Akhtar S, Majumder S. An unusual self inflicted burn in an asthmatic patient. Burns. 2003;29(2):191-192. doi: 10.1016/S0305-4179(02)00274-7
Charlier P, Deo S, Kluger N. Jailhouse self induced lesions by misuse of salbutamol inhaler. Int J Dermatol. 2019;58(9). doi: 10.1111/ijd.14434
Gunnare S, Ernstgård L, Sjögren B, Johanson G. Toxicokinetics of 1,1,1,2-tetrafluoroethane (HFC-134a) in male volunteers after experimental exposure. Toxicol Lett. 2006;167(1):54-65. doi: 10.1016/j.toxlet.2006.08.009
Zhao Y, Sun H, Lin F, Yang H. Acute, repeated inhalation toxicity, respiratory system irritation, and mutagenicity studies of 1,1,2,2-tetrafluoroethane (HFC-134) as the impurity in the pharmaceutical propellant 1,1,1,2-tetrafluoroethane (HFA-134a). Drug Chem Toxicol. 2023;46(5):841-850. doi: 10.1080/01480545.2022.2104866
Alexander D, Libretto S. An overview of the toxicology of HFA-134a (1,1,1,2-tetrafluoroethane). Hum Exp Toxicol. 1995;14(9):715-720. doi: 10.1177/096032719501400903
National Center for Biotechnology Information. PubChem Compound Summary for CID 13129, 1,1,1,2-Tetrafluoroethane. Accessed May 16, 2024. https://pubchem.ncbi.nlm.nih.gov/compound/1_1_1_2-Tetrafluoroethane
Minton NA, Baird AR, Henry JA. Modulation of the effects of salbutamol by propranolol and atenolol. Eur J Clin Pharmacol. 1989;36(5):449-453. doi: 10.1007/BF00558068
Baik MA, Alessa HM, Mohammed AH, et al. Diagnosis, complication and treatment of acute salbutamol toxicity. Int J Community Med Public Health. 2022;9(12):4669. doi: 10.18203/2394-6040.ijcmph20222970
Ramoska EA, Henretig F, Joffe M, Spiller HA. Propranolol treatment of albuterol poisoning in two asthmatic patients. Ann Emerg Med. 1993;22(9):1474-1476. doi: 10.1016/S0196-0644(05)81999-7
Boucher A, Payen C, Garayt C, et al. Salbutamol misuse or abuse with fatal outcome: A case-report. Hum Exp Toxicol. 2011;30(11):1869-1871. doi: 10.1177/0960327110388957
Milano G, Chiappini S, Mattioli F, Martelli A, Schifano F. β-2 Agonists as Misusing Drugs? Assessment of both Clenbuterol- and Salbutamol-related European Medicines Agency Pharmacovigilance Database Reports. Basic Clin Pharmacol Toxicol. 2018;123(2):182-187. doi: 10.1111/bcpt.12991
Prior JG, Cochrane GM, Raper SM, Ali C, Volans GN. Self-poisoning with oral salbutamol. BMJ. 1981;282(6280):1932-1932. doi: 10.1136/bmj.282.6280.1932
Lewis LD, Essex E, Volans GN, Cochrane GM. A Study of Self Poisoning with Oral Salbutamol - Laboratory and Clinical Features. Hum Exp Toxicol. 1993;12(5):397-401. doi: 10.1177/096032719301200509
Altamimi D, AlDeeb M, Eissa M. Intentional salbutamol poisoning: report of two siblings and review of the literature. Saudi J Emerg Med. 2022:224-228. doi: 10.24911/SJEMed/72-1648299195
Uysal E, Solak S, Carus M, Uzun N, Cevik E. Salbutamol Abuse is Associated with Ventricular Fibrillation. Turk J Emerg Med. 2015;15(2):87-89. doi: 10.5505/1304.7361.2015.33230
Basso C, Burke M, Fornes P, et al. Guidelines for autopsy investigation of sudden cardiac death. Virchows Arch. 2008;452(1):11-18. doi: 10.1007/s00428-007-0505-5
Couper FJ, Drummer OH. Gas chromatographic-mass spectrometric determination of ß2-agonists in postmortem blood: application in forensic medicine. J Chromatogr B Biomed Sci App. 1996;685(2):265-272. doi: 10.1016/S0378-4347(96)00189-2
Jarvie DR, Thompson AM, Dyson EH. Laboratory and clinical features of self-poisoning with salbutamol and terbutaline. Clin Chim Acta. 1987;168(3):313-322. doi: 10.1016/0009-8981(87)90007-6
Butzbach DM. The influence of putrefaction and sample storage on post-mortem toxicology results. Forensic Sci Med Pathol. 2010;6(1):35-45. doi: 10.1007/s12024-009-9130-8
Zhou T, Zeng J, Liu S, et al. Study on the determination and chiral inversion of R-salbutamol in human plasma and urine by liquid chromatography–tandem mass spectrometry. J Chromatogr B. 2015;1002:218-227. doi: 10.1016/j.jchromb.2015.08.020
Bozzolino C, Leporati M, Gani F, Ferrero C, Vincenti M. Development and validation of an UHPLC–MS/MS method for β 2 -agonists quantification in human urine and application to clinical samples. J Pharm Biomed Anal. 2018;150:15-24. doi: 10.1016/j.jpba.2017.11.055
Abdelrahman MM. Solid-Phase Extraction and HPLC-DAD for Determination of Salbutamol in Urine Samples. Anal Chem Lett. 2018;8(1):35-45. doi: 10.1080/22297928.2017.1396918
Harps LC, Bizjak DA, Girreser U, et al. Quantitation of Formoterol, Salbutamol, and Salbutamol-4′-O-Sulfate in Human Urine and Serum via UHPLC-MS/MS. Separations. 2023;10(7):368. doi: 10.3390/separations10070368
Gill JR, McCubbin KR, Landi KK. Homicide by Asthma. Acad Forensic Pathol. 2011;1(1):122-127. doi: 10.23907/2011.014
Merigian K, Blaho K. The Role of Pharmacology and Forensics in the Death of an Asthmatic. J Anal Toxicol. 1995;19(6):522-528. doi: 10.1093/jat/19.6.522
Lewiston NJ, Rubinstein S. Sudden Death in Adolescent Asthma. Allergy Asthma Proc. 1986;7(5):448-453. doi: 10.2500/108854186778984772
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