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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 accommodation disturbances) are mild and transient in nature in view of the wide therapeutic range and topical administration.
Therapy: Treatment with ipratropium bromide + salbutamol (Combivent UDV) should be discontinued. Acid base and electrolyte monitoring should be considered. Administration of sedatives, tranquillizers, in severe cases intensive therapy.
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.
