[Hyperlactatemia induced by inhaled β2 agonists: An underrecognized side effect. Report of two cases]

Rev Med Interne. 2019 Jun;40(6):400-403. doi: 10.1016/j.revmed.2018.11.010. Epub 2018 Dec 9.
[Article in French]

Abstract

Background: Repeated use of inhaled β2 agonists is common in asthma or COPD exacerbations. It can lead to hyperlactatemia.

Case reports: We report two asthmatic patients who presented in the emergency department for an asthma exacerbation. The first patient developed hyperlactatemia at 3.9 mmol/L and the second patient developed hyperlactatemia at 5.6 mmol/L after terbutaline treatment. Both patients had a favorable outcome after adjusting the aerosol dose to clinical parameters.

Discussion: Lactic acidosis induced by the use of inhaled β2 agonists is not synonymous of clinical deterioration. However, this side effect may be complicated by a tachypnea compensating for metabolic acidosis and should be known to avoid unnecessary therapeutic escalation.

Keywords: Asthma; Asthme; Hyperlactatemia; Hyperlactatémie; β2 agonist; β2-mimétique.

Publication types

  • Case Reports

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-2 Receptor Agonists / administration & dosage
  • Adrenergic beta-2 Receptor Agonists / adverse effects*
  • Aged
  • Asthma / drug therapy
  • Female
  • Humans
  • Hyperlactatemia / chemically induced*
  • Middle Aged
  • Terbutaline / administration & dosage
  • Terbutaline / adverse effects*

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Terbutaline