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Tuesday, April 10, 2012

Does Albuterol lower potassium?

Your Question:  Does Albuterol lower potassium?

My answer:  Albuterol does have the effect of lowering potassium.  While one treatment can lower potassium in your system, it's usually by an insignificant amount.  However, if you are using a lot of Ventolin throughout the course of a day, it can have the effect of lowering potassium.  It's generally not something that's considered significant, however.  I have never heard of a physician not prescribing an asthma rescue medicine due to it's potassium lowering effect.  However, it's something to consider if you have other medical problems.  It may also be a good idea to eat a banana or two if you use Ventolin a lot, because bananas are a good source of potassium.  Maybe that's why I crave a banana for breakfast every day because I used to use Ventolin a lot.  Anyway, here is a good article written by a good friend of mine that answers your question in more detail if you're interested.  I actually wrote a post on the subject myself but it's location presently eludes me.


Anonymous said...

Actually there are some old school doctors that do order ventolin to aid in lowering potassium. I have administered it for that purpose several times. However, they don't just order 2.5 mg, they order a 10 mg treatment followed by another 10 mg treatment after about 15 minutes to keep a close watch on the heart rate. The studies that I have seen state that it takes about 20 mg to have a significant effect on potassium.

Rick Frea said...

Agreed. The recommended dose for lowering potassium is 5-20 mg run over 20 minutes.

However, in defense of doctors who order it, I have seen studies recently that Albuterol (or epi or xopenex) start to reduce potassium even after just one treatment.

I'll post those studies here as soon as I find them (if I find them).

Rick Frea said...

Well, I was unable to find the study I was referring to, so for the time being we're going to have to assume it doesn't exist. I have, however, found the following articles that verify the therapeutic dose of albuterol for the treatment of hyperkalemia as 5-20mg over 15-20 minutes. Although, the second one does not recommend it as a topline therapy, as you can read for yourlself.

1. "Hyperkalemia Revisited" (Parham, Walter A, et al, Tex Heart Inst J. 2006; 33(1): 40–47

2. "Controversial issues in the treatment of hyperkalemia," Nephrology Dialysis Transplantation, 2003, Vol. 18, Issue 11, pages 2215-2218)

You should be able to find both articles by doing a Google search.

Rick Frea said...

I will have a post with more information about this topic on September 26, 2012. So stay tuned. If anyone has any evidence either way, let me know.