Moderate
Established
الوصف
Albuterol-induced hypokalaemia can potentiate digoxin toxicity by increasing myocardial sensitivity to digoxin at any given plasma concentration.
الآلية
Beta-2 agonists stimulate Na+/K+-ATPase, shifting potassium intracellularly and lowering serum potassium; hypokalaemia enhances binding of digoxin to myocardial Na+/K+-ATPase, increasing toxicity risk.
الأهمية السريرية
Even modest albuterol-induced potassium falls (0.3–0.6 mmol/L) can push digoxin into a toxic range in borderline patients; arrhythmias have been reported.
التدبير
Monitor serum potassium and digoxin levels in patients on both drugs; ensure adequate potassium intake and consider potassium supplementation if hypokalaemia develops.