Nebulised salbutamol challenge confirming life-threatening paradoxical bronchospasm

Paradoxical bronchospasm: a rare adverse effect of fenoterol use

Paradoxical bronchospasm refers to the constriction of the airways after treatment with a sympathomimetic bronchodilator. Theoretically, bronchodilators, such as beta-agonist inhalers, act to ease asthma symptoms by relaxing the muscles surrounding the walls of the bronchial tubes, which relieve bronchial constriction. However, in rare instances, some patients develop respiratory distress or even respiratory failure after inhaled bronchodilator use, although the exact mechanism for this adverse effect is unknown. We report a male, with a known asthma history diagnosed for more than one decade, receiving fenoterol (Berotec®) for wheezing control and the worsening of his clinical condition immediately after bronchodilator administration.