Metin UYSALOL, Raif YILDIZ, Zeynep Güneş ÖZÜNAL

Is Seizure an Adverse Effect of Salbutamol in the Pediatric Population?

Background: Although studies on epileptic seizures occurring during acute asthma attacks are limited, there is widespread belief among families and physicians that salbutamol causes seizures. Aims: To investigate whether salbutamol triggers seizures in patients with epilepsy and asthma. Study Design: A retrospective cohort study. Methods: Epilepsy and asthma in patients aged 2-18 years who were admitted to the pediatric emergency department because of asthma attacks between January 2016 and December 2016 in a university hospital were evaluated retrospectively. The inclusion criteria were age 2–18 years, previous diagnosis of epilepsy and asthma, and admission to the pediatric emergency department due to asthma attacks. Results: 276 medical records were evaluated. The seizure group had a longer period of diagnosis for epilepsy than the seizure absent group in the pediatric emergency department (5.4 years and 3.1, respectively). According to the logistic regression analysis, the duration of seizures in the emergency department, duration of asthma diagnosis, duration of epilepsy diagnosis, uncontrolled asthma, and severity of asthma attack in the pediatric emergency department have significantly increased the possibility of having a seizure during an asthma attack in our study population. Conclusion: This study shows that patients using salbutamol have a lower risk of epileptic seizures than those who do not use salbutamol. This result should be verified by studies containing a large number of patients.

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Ortiz-Alvarez O, Mikrogianakis A; Canadian Paediatric Society, Acute Care Committee. Managing the paediatric patient with an acute asthma exacerbation. Paediatr Child Health. 2012;17:251-262. [CrossRef]
Louridas G, Kakoura M, Galanis N, Patakas D, Kastritsi K. Bronchodilatory effect of inhaled versus oral salbutamol in bronchial asthma. Respiration. 1983;44:439-443. [CrossRef]
Pratt H. Abuse of salbutamol inhalers in young people. Clin Allergy. 1982;12:203- 208. [CrossRef]
Caccia S, Fong MH. Kinetics and distribution of the beta-adrenergic agonist salbutamol in rat brain. J Pharm Pharmacol. 1984;36:200-202. [CrossRef]
King WD, Holloway M, Palmisano PA. Albuterol overdose: a case report and differential diagnosis. Pediatr Emerg Care. 1992;8:268-271. [CrossRef]
Chen HY, Albertson TE, Olson KR. Treatment of drug-induced seizures. Br J Clin Pharmacol. 2016;81:412-419. [CrossRef]
Global initiative for asthma management and prevention, 2022. Available at: https:// ginasthma.org/wp-content/uploads/2022/05/GINA-Main-Report-2022-FINAL-22- 05-03-WMS.pdf. Accessed 10 May 2022. [CrossRef]
Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55:475–482. [CrossRef]
Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010;51:1069-1077. [CrossRef]
Scarberry J, Smalligan RD. Albuterol induced myoclonus. J Investig Med. 2008:56:408[CrossRef]
Mícheli F, Cersósimo MG, Scorticati MC, Velez M, Gonzalez S. Myoclonus secondary to albuterol (salbutamol) instillation. Neurology. 2000;54:2022-2023. [CrossRef]
Castaneda GY, Heilbroner PL, Shah N, Forem S, Fish I. Asthma and epilepsy: are they related? A retrospective study. J Child Neurol. 1998;13:283-285. [CrossRef]
Bilan N, Ghaffari S. Association of Asthma and Epilepsy. Res J Biol Sci. 2008;3:1370- 1372.
Nellhaus G, Neuman I, Ellis E, Pirnat M. Asthma and Seizures in children. Pediatr Clin North Am. 1975;22:89-100. [CrossRef]
Gullach AJ, Risgaard B, Lynge TH, et al. Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark. BMC Pulm Med. 2015;15:35. [CrossRef]
Issakainen JP, Koivikko MJ, Häkkinen VK. Electroencephalogram during and after an acute attack of asthma in children. Allergy. 1982;37:291-295. [CrossRef]
de Wet CJ, Mellers JD, Gardner WN, Toone BK. Pseudoseizures and asthma. J Neurol Neurosurg Psychiatry. 2003;74:639-641. [CrossRef]
Singh A, Gulati K, Chhabra SK, Dubey H, Kalaiselvan V, Ray A. Aggravation of Seizure after Combined Nebulisation with Albuterol and Ipratropium Bromide. J of Pharmacol & Clin Res. 2018;6:555681. [CrossRef]
Sazgar M, Bourgeois BF. Aggravation of epilepsy by antiepileptic drugs. Pediatr Neurol. 2005;33:227-234. [CrossRef]
Świąder M, Zakrocka I, Świąder K, et al. Influence of salbutamol on the anticonvulsant potency of the antiepileptic drugs in the maximal electroshock-induced seizures in mice. Pharmacol Rep. 2019;71:466-472. [CrossRef]
Nwaru BI, Ekström M, Hasvold P, Wiklund F, Telg G, Janson C. Overuse of shortacting β2-agonists in asthma is associated with increased risk of exacerbation and mortality: a nationwide cohort study of the global SABINA programme. Eur Respir J. 2020;55:1901872. [CrossRef]