Terbutaline Sulphate
Indications
Terbutaline Sulphate is used for:
Acute bronchospasm
Adult Dose
Oral
Acute bronchospasm
Adult: Initiate at 2.5 mg three/four times daily
Maintenance: 5 mg three times daily q6hr while patient is awake; reduce dose to 2.5 mg q6hr
Not to exceed 15 mg/Day
Child Dose
Oral
Acute bronchospasm
Child: <12 years: 0.05 mg/kg three times daily initially; increase PRN, not to exceed 5 mg/day
12-15 years: 2.5 mg PO q6hr 3 times daily; not to exceed 7.5 mg/day
>15 years: 5 mg/dose PO q8hr three times daily; reduce dose to 2.5 mg q6hr; not to exceed 15 mg/24hr
Renal Dose
Renal Impairment
GFR <50 mL/min: reduce dose by 50%
GFR >50mL/min: Dose adjustment not necessary
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity to sympathomimetics. Any condition of mother or foetus in which prolongation of pregnancy is dangerous.
Precautions
Patient w/ thyrotoxicosis, HTN, DM, ketoacidosis, CV disorders (e.g. ischaemic heart disease), convulsive disorders, coronary insufficiency or associated arrhythmias. Childn. Pregnancy and lactation. Monitoring Parameters Monitor cardiorespiratory function, serum K and glucose levels;
Lactation: Distributed into breast milk, but in amounts generally considered insufficient to affect nursing infants (AAP Committee states compatible with nursing)
Pregnancy-Lactation
Pregnancy Category: C
Lactation: Distributed into breast milk, but in amounts generally considered insufficient to affect nursing infants (AAP Committee states compatible with nursing)
Interactions
Antagonised effects of beta-blockers. Increased risk of hypokaelemia with xanthine derivatives, corticosteriods and diuretics; increased risk of arrhythmias with inhaled anaesthetics, sympathomimetics.
Adverse Effects
Side effects of Terbutaline Sulphate :
Tachycardia, nervousness, tremor, palpitations, dizziness, headache, nausea, vomiting, anxiety, restlessness, lethargy, drowsiness, weakness, flushes, sweating, chest discomfort, muscle cramps, tinnitus. Rarely, seizures, hypersensitivity vasculitis, elevated liver enzymes.
Potentially Fatal: Increased heart rate, transient hyperglycaemia, hypokalaemia, cardiac arrhythmias, pulmonary oedema, myocardial ischaemia.
Mechanism of Action
Terbutaline is a direct-acting sympathomimetic which relaxes bronchial smooth muscle by selective action on beta2 receptors. It also decreases uterine contractility.