Which adverse event may occur with excessive Albuterol administration?

• A. Hyperkalemia
• B. Paradoxical bronchospasm
• C. Chelation
• D. Renal failure

Answer: (B)

Paradoxical bronchospasm is the adverse event to recognize with excessive albuterol. Albuterol stimulates beta-2 receptors to relax bronchial smooth muscle and open airways, but when given in too high a dose or too frequently, it can irritate the airways or trigger a reflex constriction, causing wheezing and coughing to worsen instead of improve. This paradoxical response, though uncommon, is a known potential effect of overuse or improper delivery.

Hyperkalemia wouldn’t fit because beta-agonists tend to drive potassium into cells, often causing hypokalemia rather than hyperkalemia. Chelation and renal failure are not typical direct adverse effects of albuterol. In practice, expect tachycardia, tremor, and possible hypokalemia with excessive use, with paradoxical bronchospasm being the specific paradoxical reaction to watch for.