Overdose Beta agonist: Mystery of young girl, asthmatic, clear lungs, tachycardic, hyperventilation & metabolic acidosis.

Metabolic acidosis as adverse effect of Beta agonist

How?

-Beta angonist cause increased in cAMP.

-cAMP promote glycogenolysis , lipolysis and glycolysis.

-glycogenolysis produce glucose-6-phosphate.

-usually glycogenolysis occurs in liver and skeletal muscle.

-glucose-6-phosphate produce in the liver will be converted to glucose by glucose-6-phosphatase and then release to the blood to be use.

-But in skeletal muscle, there is lack of this enzyme (glucose-6-phosphatase).

-hence glucose-6-phosphate that produced in the skeletal will be convert to pyruvate to enter Krebs cycles for energy production.

-however, the high concentration of fatty acid (increase lipolysis stimulate by cAMP) inhibit oxidation of pyruvate to Acetyl CoA to enter the Krebs cycle.

-the abundance of pyruvates converted to lactate.

Apart from Beta agonist, glucocorticoids and theophylline also increase the cAMP production.

Ref:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3862915/#!po=52.2727

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