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Terbutaline
Aka: Terbutaline, Brethine, Bricanyl
- See Also
- Preterm Labor Management
- Tocolytic
- Indications
- Preterm Labor
- Asthma
- Contraindications
- Antepartum Hemorrhage
- Cardiovascular disease
- Hyperthyroidism
- Uncontrolled Diabetes Mellitus
- 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)
- 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
- 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
- Lewis (1996) Am J Obstet Gynecol 175:834-7 [PubMed]
- Adverse Effects
- Maternal Tachycardia
- Fetal Tachycardia
- Tremor
- Palpitations
- Anxiety
- Shortness of Breath
- Pulmonary Edema
- Monitoring
- Baseline testing to consider
- Electrocardiogram
- Serum Glucose
- Serum Potassium
- Complete Blood Count
- Type and screen
- 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