The Annals of pharmacotherapy · 1992
Possible association of benzalkonium chloride in nebulizer solutions with respiratory arrest.
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Boucher M, Roy M T, Henderson J
Аннотация
OBJECTIVE: To report a case of possible association of benzalkonium chloride in nebulizer solutions with respiratory arrest and to review the involvement of various preservative agents in paradoxical bronchoconstrictive reactions.
DATA SOURCES: Reference articles, case reports, and editorials are identified in the text.
DATA SYNTHESIS: Many pharmacologic agents are available for nebulization. In addition to the active drug, these nebulizer solutions may contain preservatives. We describe a case of respiratory arrest in a 64-year-old man following nebulization therapy with albuterol and ipratropium solutions. These solutions contain benzalkonium chloride as a preservative. We are aware of only one report describing two deaths associated with such a severe reaction attributable to nebulization therapy. However, many reports of milder paradoxical bronchoconstriction are available in the medical literature.
CONCLUSIONS: Clinicians should be aware of the possibility of paradoxical bronchoconstrictive reactions when patients are treated with nebulized bronchodilators.
DATA SOURCES: Reference articles, case reports, and editorials are identified in the text.
DATA SYNTHESIS: Many pharmacologic agents are available for nebulization. In addition to the active drug, these nebulizer solutions may contain preservatives. We describe a case of respiratory arrest in a 64-year-old man following nebulization therapy with albuterol and ipratropium solutions. These solutions contain benzalkonium chloride as a preservative. We are aware of only one report describing two deaths associated with such a severe reaction attributable to nebulization therapy. However, many reports of milder paradoxical bronchoconstriction are available in the medical literature.
CONCLUSIONS: Clinicians should be aware of the possibility of paradoxical bronchoconstrictive reactions when patients are treated with nebulized bronchodilators.