Combivent Overdosage

Symptoms: The effects of overdosage are expected to be primarily related to salbutamol.
The expected symptoms with overdosage are those of excessive beta-adrenergic-stimulation, the most prominent being tachycardia, palpitation, tremor, hypertension, hypotension, hypokalaemia, widening of the pulse pressure, anginal pain, arrhythmias and flushing. Metabolic acidosis has also been observed with overdosage of salbutamol.
Expected symptoms of overdosage with ipratropium bromide (such as dry mouth, visual accomodation disorders) are mild and transient in nature in view of the wide therapeutic range and topical administration.
Therapy: Treatment with COMBIVENT should be discontinued. Acid base and electrolyte monitoring should be considered.
Administration of sedatives, and in severe cases intensive therapy may be needed.
Beta-receptor blockers, preferably beta₁-selective, are suitable as specific antidotes; however, a possible increase in bronchial obstruction must be taken into account and the dose should be adjusted carefully in patients suffering from bronchial asthma.