A comparison of the extent and duration of hypokalaemia following three nebulized beta₂-adrenoceptor agonists

Summary

The hypokalaemic effects of equal doses (5 mg) of fenoterol, salbutamol, terbutaline and an equal volume of saline administered by nebulization were compared in eight healthy subjects. Plasma potassium was measured at 15-min intervals for 60 min and at 90 min, 2, 4 and 6 h following administration.

Fenoterol, salbutamol and terbutaline all significantly decreased plasma potassium when compared to saline; however, the magnitude and duration of this effect differed between the active agents. Both fenoterol and terbutaline significantly reduced plasma potassium for 4 h whereas salbutamol was only different from 30 to 120 min. The maximum decrease occurred with fenoterol (−0.78 mmol/l), followed by terbutaline (−0.70 mmol/l) and salbutamol (−0.33 mmol/l). Both terbutaline and fenoterol had a significantly greater effect compared with salbutamol.

When administered by nebulization fenoterol and terbutaline are likely to have a greater hypokalaemic effect then salbutamol and this effect is likely to be more long lasting.