Tremor and β(2)-adrenergic agents: is it a real clinical problem?

Pulmonary Pharmacology & Therapeutics
Mario Cazzola, Maria Gabriella Matera

Abstract

Tremor is one of the most characteristic adverse effects following administration of β(2)-adrenergic agonists. It is reported by around 2-4% of patients with asthma taking a regular β(2)-adrenergic agonist and is induced by both short-acting and long-acting agents. Tremor associated with β(2)-adrenergic agonists is dose-related and may occur more commonly with oral dosing. The exact mechanism for tremor induction by β(2)-adrenergic agonists is still unknown, but there is some evidence that β(2)-adrenergic agonists act directly on muscle. An early explanation of the tremor was that β(2)-adrenoceptor stimulation shortens the active state of skeletal muscle, which leads to incomplete fusion and reduced tension of tetanic contractions. More recently, tremor has been correlated closely with hypokalaemia. A possible diverse impact of different modes of administration of β(2)-adrenergic agonists on tremorogenic responses has been suggested but solid evidence is still lacking. In any case, the desensitization of β(2)-adrenoceptors that occurs during the first few days of regular use of a β(2)-adrenergic agonist accounts for the commonly observed resolution of tremor after the first few doses. Therefore, tremor is not a really important...Continue Reading

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Jul 7, 2012·European Journal of Applied Physiology·Anthony M J SanchezRobin Candau
Feb 11, 2014·Clinics in Chest Medicine·Mario Cazzola, Maria Gabriella Matera
Mar 1, 2016·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Maria Gabriella MateraMario Cazzola
Jan 24, 2018·Journal of Applied Physiology·Carlos Alberto ArcaroAmanda Martins Baviera
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Jan 26, 2013·American Journal of Respiratory and Critical Care Medicine·Mario CazzolaMaria Gabriella Matera

Related Concepts

Aerosol Dose Form
Broncholytic Effect
Drug Tolerance
Static Tremor
Adrenergic beta-2 Receptor Agonists
Asthma
Membrane Fusion
Muscle
Beta-adrenergic receptor
Oral Cavity

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