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Inhaled albuterol rapidly decreases whole blood potassium and increases plasma insulin concentrations, with peak effects 30 minutes after administration in cats
Journal article   Open access   Peer reviewed

Inhaled albuterol rapidly decreases whole blood potassium and increases plasma insulin concentrations, with peak effects 30 minutes after administration in cats

Jared A Jaffey, Anderson da Cunha, Tokiko Kushiro-Banker, Renata S Costa, Mark Acierno, Chase Irwin, Lauren Chittick, Natacha Montalvo, Mia Felix, Megan Valentine, …
Journal of the American Veterinary Medical Association
2025
PMID: 40139156
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CC BY-NC V4.0 Open Access

Abstract

albuterol feline potassium β2 agonist hyperkalemia
Objective To characterize the effects of inhaled albuterol on blood potassium and glucose concentrations, heart rate (HR), and plasma insulin levels in normokalemic cats. Methods In a prospective, randomized study between June 2023 and January 2024, 20 client-owned cats received albuterol sulfate at a low dose (90 µg) or high dose (360 µg). Blood samples and HR were obtained at baseline and 10 time points after albuterol delivery. Blood potassium and glucose concentrations were measured via blood gas analyzer and plasma insulin levels by radioimmunoassay. Results Blood potassium concentrations decreased rapidly after albuterol delivery compared to baseline for the low dose and high dose within 3 minutes and remained significantly decreased until 180 minutes. The maximal decrease in potassium concentration for albuterol at the low dose was –0.52 mmol/L (95% CI, –0.66 to –0.37) and high dose was –0.38 mmol/L (95% CI, –0.52 to –0.23) and occurred at 30 minutes for both doses. Plasma insulin levels rapidly increased, with peak effect at 30 minutes for both the low dose (5.10 µIU/mL; 95% CI, 2.79 to 7.40) and high dose (3.86 µIU/mL; 95% CI, 1.49 to 6.22). There was no correlation between nadir potassium concentration and albuterol dose (r = 0.12). Conclusions Albuterol rapidly decreases blood potassium concentrations in part by stimulating endogenous insulin secretion in cats without dose-dependent effects or clinically meaningful changes in HR or glucose concentrations. Clinical Relevance Inhaled albuterol may be useful to decrease blood potassium concentrations in hyperkalemic cats.

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