Levalbuterol Lowers Potassium and Has Fewer Side Effects Than Albuterol

Emergency department patients with life-threatening hyperkalemia may receive a number of interventions to lower serum potassium levels, including high-dose albuterol (10-20 mg). These authors compared how levalbuterol (the purified R-enantiomer of racemic albuterol; 2.5 mg), an equivalent dose of albuterol (10 mg), and normal saline affected the serum potassium levels of 27 healthy, nonpregnant adult volunteers. Subjects who had cardiac or pulmonary disease or who were taking medications that affect serum potassium levels were excluded.

Participants were randomized to receive equal volumes of nebulized levalbuterol, albuterol, or saline over a 30-minute period. Investigators measured serum potassium levels via an indwelling catheter at basel…