Prox-S Overdosage

Symptoms: The most common signs and symptoms of overdose with salbutamol are transient beta agonist pharmacologically mediated events, including tachycardia, tremor, hyperactivity and metabolic effects including hypokalemia.
Salbutamol overdose may lead to hypokalemia (abnormally low potassium concentration in the blood). Serum potassium levels should therefore be monitored.
Lactic acidosis has been reported in association with high therapeutic doses as well as overdoses of short-acting beta-agonist therapy, therefore monitoring for elevated serum lactate and consequent metabolic acidosis (particularly if there is persistence or worsening of tachypnea despite resolution of other signs of bronchospasm such as wheezing) may be indicated in the setting of overdose.
Nausea, vomiting and hyperglycemia have been reported, predominantly in children and when salbutamol overdose has been taken via the oral route.
Treatment: The preferred antidote for overdose with salbutamol sulfate is a cardio-selective beta-blocking agent, which should be used with caution in patients with a history of bronchospasm. Further management should be as clinically indicated or as recommended by the national poisons center, where available.