A patient with severe asthma may develop a lactic acidosis associated with high doses of inhaled beta-agonists.


Initial clinical findings:

(1) The patient is having an exacerbation of asthma.

(2) The patient is treated aggressively, with therapy including inhaled beta-agonists.

(3) The patient is noted to be tachypneic.


Laboratory testing shows:

(1) There is a metabolic acidosis associated with elevated lactic acid.

(2) The PaCO2 is usually not elevated.


The patient quickly improves on discontinuation of beta-agonist therapy.


No other explanation for lactic acidosis is identified.


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