From the FDA Drug Label
Manifestations of overdosage may include ... tachycardia with rates up to 200 beats/min The FDA drug label does not answer the question.
From the Research
A heart rate below 100 beats per minute is generally considered safe for a patient to leave the office after receiving albuterol treatment. If the patient presented with a heart rate of 130 bpm and had recently used albuterol, they should be monitored until their heart rate decreases to under 100 bpm, ideally returning to their baseline. Albuterol is a beta-2 agonist that can cause tachycardia as a side effect, which typically resolves within 1-2 hours as the medication's effects diminish 1. While monitoring the patient, assess for other concerning symptoms such as chest pain, shortness of breath, dizziness, or palpitations. If the heart rate remains elevated above 100 bpm after 1-2 hours of observation, or if the patient develops additional concerning symptoms, further evaluation may be necessary to rule out other causes of tachycardia. Adequate hydration and rest in the office may help reduce the heart rate more quickly. For patients with known cardiac conditions, a more conservative approach with a heart rate closer to their baseline may be appropriate before discharge.
Some key points to consider when managing a patient with a high heart rate after albuterol use include:
- Monitoring the patient's heart rate and other vital signs closely
- Assessing for other concerning symptoms such as chest pain or shortness of breath
- Providing adequate hydration and rest to help reduce the heart rate
- Considering a more conservative approach for patients with known cardiac conditions
- Being aware of the potential for albuterol to cause tachycardia and other cardiovascular effects, as noted in studies such as 2 and 1.
It's also important to note that the use of beta-blockers, such as bisoprolol, may be beneficial in certain cases, as they have been shown to be effective in reducing the risk of arrhythmias and other cardiovascular events 3, 4. However, the decision to use beta-blockers should be made on a case-by-case basis, taking into account the individual patient's medical history and current condition.