A 14-year-old girl with newly diagnosed asthma is prescribed inhaled salbutamol for acute episodes. Her mother asks about potential systemic side effects. Which metabolic effect is most likely associated with high-dose beta-2 agonist therapy?
- A Hypokalemia ✓
- B Hypernatremia
- C Hypercalcemia
- D Hypophosphatemia
Correct answer: A. Hypokalemia
Explanation
Beta-2 agonism activates Na+/K+-ATPase, driving potassium intracellularly and causing hypokalemia. This is particularly relevant with high-dose inhaled or nebulized salbutamol in acute asthma. Hypokalemia may predispose to cardiac arrhythmias, especially when combined with theophylline or hypoxia.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
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