Küng M, White J R, Burki N K
Am Rev Respir Dis. 1984 Feb;129(2):329-32.
Several recent reports have linked the administration of beta-adrenergic agents to the development of hypokalemia. This led us to study, under controlled conditions, the effects of a subcutaneous injection of 0.25 mg terbutaline sulfate on serum potassium (K+), sodium (Na+), glucose, and insulin in a group of asymptomatic asthmatics. Heart rate (HR), blood pressure (BP), and forced expiratory volume in one second (FEV) were measured as parameters of beta-adrenergic stimulation. Each of 7 subjects was studied on 2 separate mornings after an overnight fast. Measurements were obtained before and at various time intervals after 0.25 mg) of terbutaline sulfate or 0.25 ml of a normal saline solution (placebo) were injected subcutaneously in a double-blind randomized crossover fashion. Terbutaline injection significantly increased HR and FEV and lowered diastolic BP for a period in excess of 3 h, indicating a prolonged beta stimulatory action of the drug. Significant effects on glucose, K+, and insulin were observed as early as 15 min after terbutaline injection; serum glucose and insulin increased and remained elevated for at least 2 h. Serum K+ fell significantly, reached a peak decline of 14% from the control value at 30 min after the injection and remained decreased for a period in excess of after subcutaneous terbutaline injection should be interpreted in the light of these effects of the drug and that terbutaline should be used with caution in patients prone to hypokalemia.
最近的几份报告将β-肾上腺素能药物的使用与低钾血症的发生联系起来。这促使我们在可控条件下，研究皮下注射0.25毫克硫酸特布他林对一组无症状哮喘患者血清钾（K+）、钠（Na+）、葡萄糖和胰岛素的影响。测量心率（HR）、血压（BP）和一秒用力呼气量（FEV）作为β-肾上腺素能刺激的参数。7名受试者中的每一位都在禁食过夜后的两个不同早晨接受研究。在以双盲随机交叉方式皮下注射0.25毫克硫酸特布他林或0.25毫升生理盐水（安慰剂）之前和之后的不同时间间隔进行测量。特布他林注射使HR和FEV显著增加，并使舒张压在超过3小时的时间内降低，表明该药物具有延长的β刺激作用。早在特布他林注射后15分钟就观察到对葡萄糖、K+和胰岛素有显著影响；血清葡萄糖和胰岛素增加并至少升高2小时。血清K+显著下降，注射后30分钟时从对照值峰值下降14%，并在超过2小时的时间内持续降低。皮下注射特布他林后的这些效应应结合药物的这些作用来解释，并且特布他林在易患低钾血症的患者中应谨慎使用。
