II. Indications
III. Contraindications
- Antepartum Hemorrhage
- Cardiovascular disease
- Hyperthyroidism
- Uncontrolled Diabetes Mellitus
IV. Mechanism
- Ethanolamine derivative with selective beta-2 adrenergic activity (bronchodilation, Tocolysis)
- Triggers intracellular adenyl cyclase activation with secondary increase in cAMP
- Bronchial Smooth Muscle relaxation
- Vascular Smooth Muscle relaxation
- Reduces Calcium movement across cell membranes resulting in Smooth Muscle relaxation
- Triggers glycogenolysis and Gluconeogenesis
V. Dosing: Preterm Labor
- Subcutaneous
- Dose: 0.25 mg SQ every 1-4 hours for 24 hours
- Maximum: 5 mg in 24 hours
- Intravenous
- Start: 10 mcg/minute
- Increase rate by 5 mcg per minute every 10 minutes
- Maximum: 25 mcg per minute
- Once controlled, decrease dose 5 mcg every 30 minutes
- Titrate dose down to lowest effective dose
- Oral (not effective and not recommended)
- Dose: 2.5 to 7.5 mg PO every 1.5 to 4 hours
- Hold for maternal pulse >100 beats per minute
- Subcutaneous Pump
- Basal rate: 0.05 to 0.10 mg/hour
- Boluses: 0.25 mg
VI. Dosing: Asthma
-
Status Asthmaticus
- Terbutaline may be used as an alternative to the preferred Epinephrine
- Adult
- Dose: 0.25 mg SQ lateral deltoid now (may repeat up to once within 15 to 30 min)
- Maximum: 0.5 mg per 4 hours
- Child (off-label)
- Dose: 0.01 mg/kg (up to 0.25 mg) SC every 20 min for up to 3 doses
- May be repeated up to every 2-6 hours as needed
-
Asthma rescue Inhaler
- Terbutaline was previously available in U.S. as BrethaireInhaler
- Had been used as a Short-acting Beta Agonist rescue Inhaler similar to Albuterol
VII. Efficacy
- Effective at temporarily stopping contractions
- Results in shortest hospital triage stays
- Guinn (1997) Am J Obstet Gynecol 177:814-87 [PubMed]
- Oral Terbutaline is not effective in Preterm Labor
VIII. Adverse Effects
IX. Monitoring
- Baseline testing to consider
- Close monitoring
- Blood Pressure for Hypertension
- Pulse for maternal Tachycardia over 100
- Lung Exam for signs of Pulmonary Edema
- Follow Serum Glucose and Serum Potassium
- Consider fluid restriction <2400 cc per day
X. Resources
Images: Related links to external sites (from Bing)
Related Studies
| terbutaline (on 11/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| TERBUTALINE SULFATE 2.5 MG TAB | Generic | $1.78 each |
Ontology: Terbutaline (C0039542)
| Definition (NCI) | An ethanolamine derivative with bronchodilating and tocolytic activities. Terbutaline selectively binds to and activates beta-2 adrenergic receptors, leading to intracellular adenyl cyclase activation via a trimeric G protein and subsequent increase in cyclic AMP (cAMP) production. Increased cAMP levels result in relaxation of bronchial and vascular smooth muscle mediated through the activation of protein kinase A (PKA), which phosphorylates proteins in control of muscle tone. cAMP also inhibits calcium ion release from intracellular stores, reduces calcium entry into cells and induces the sequestration of intracellular calcium all of which aids in the relaxation of airway muscles. Terbutaline also increases mucociliary clearance and reduces release of inflammatory cell mediators. |
| Definition (MSH) | A selective beta-2 adrenergic agonist used as a bronchodilator and tocolytic. |
| Definition (CSP) | beta-adrenergic receptor agonist used as a bronchodilator and tocolytic. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D013726 |
| SnomedCT | 372745006, 45311002 |
| LNC | LP17982-7, MTHU013595 |
| English | Terbutaline, 1,3-Benzenediol, 5-(2-((1,1-dimethylethyl)amino)-1-hydroxyethyl)-, Terbutaline [Chemical/Ingredient], terbutaline, TERBUTALINE, Terbutaline (product), Terbutaline (substance) |
| Swedish | Terbutalin |
| Czech | terbutalin |
| Finnish | Terbutaliini |
| Russian | TERBUTALIN, ТЕРБУТАЛИН |
| Japanese | ブリスチュリン, 硫酸テルブタリン, テルブタリン硫酸塩, ブリカニール, コンボン, テルブタリン |
| Croatian | TERBUTALIN |
| Polish | Terbutalina |
| Spanish | terbutalina (producto), terbutalina (sustancia), terbutalina, Terbutalina |
| French | Terbutaline |
| German | Terbutalin |
| Italian | Terbutalina |
| Portuguese | Terbutalina |
Ontology: Bricanyl (C0591192)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D013726 |
| English | bricanyl, Bricanyl, Bricanyl SA, AstraZeneca Brand of Terbutaline Sulfate, Hoechst Brand of Terbutaline Sulfate, Terbasmin, pharma-stern Brand of Terbutaline Sulfate |
Ontology: Brethine (C0701014)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D013726 |
| English | brethine, Brethine, Novartis Brand of Terbutaline Sulfate |
