mechanism by which salbutamol nebulisation causing Hypokalemia

                            Normally, we are using salbutamol nebulisation in relieving bronchospasm associated with many respiratory disorders such as asthma.Salbutamol is a selective beta2 agonist

and thereby a fast acting bronchodilator with peak effect within 10 minutes.It's side effects include tremors,palpitation,nervousness.In addition to this, it causes hypokalemia by moving potassium into the cell.




                  We know,normal potassium level is 3.5-5.5Meq/dl.The mechanism by which Salbutamol causes hypokalemia is that it increases the blood glucose level.It in turn causes an increase in blood insulin level which activates Na-K pump ,moving potassium into the cell ,causing reduced serum potassium levels.

POSITION OF PATIENT

NEBULISER

                      










                  






                              Hypokalemia causes metabolic alkalosis ,muscle weakness,confusion etc.In ECG, it produce U wave due to purkinje fibre repolarisation.Even though Salbutamol decreases serum potassium level,it is used with caution in conditions such as, after cardiac surgeries,other cardiac diseases etc .The reason is that it will increase cardiac work load by increasing the heart rate.



Thank you very much.....