Names and pronunciation
(ter-byoo′ta-leen)
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Individual generic drug information
Extracted information for terbutaline only.
(ter-byoo′ta-leen)
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Func. class.: Selective β2-agonist; bronchodilator
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Chem. class.: Catecholamine
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ACTION: Relaxes bronchial smooth muscle by direct action on β2-adrenergic receptors through the accumulation of cAMP at β-adrenergic receptor sites; bronchodilation, diuresis, CNS, cardiac stimulation occur; relaxes uterine smooth muscle
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USES: Bronchospasm
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Unlabeled uses: Premature labor, nonresponsive status asthmaticus in chil- dren (IV)
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Extracted information for terbutaline only.
CONTRAINDICATIONS: Hyper- sensitivity to sympathomimetics, closed- angle glaucoma, tachydysrhythmias Precautions: Pregnancy, breastfeeding, geriatric patients, cardiac disorders, hyperthyroidism, diabetes mellitus, pros- tatic hypertension, hypertension, seizure disorder
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Black Box Warning: Premature labor Black Box Warning: Premature labor: maternal heart rate, B/P, contraction, fetal heart rate; can inhibit uterine contrac- tions, labor; monitor for hypoglycemia; do not use injectable product for prevention or treatment over 72 hr in preterm labor; do not use oral product for preterm labor; avoid breastfeeding
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SIDE EFFECTS CNS: Tremors, anxiety, insomnia, head- ache, dizziness, stimulation, restlessness CV: Palpitations, tachycardia, hyperten sion, dysrhythmias, cardiac arrest, QT T prolongation GI: Nausea, vomiting META: Hypokalemia, hyperglycemia RESP: bronchospasm, Paradoxical dyspnea MS: Muscle cramps SYST: Angioedema, hypersensitivity
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INTERACTIONS Increase: hypertensive crisis—MAOIs Increase: effects of both products— other sympathomimetics Decrease: action—β-blockers; do not use together Drug/Herb Increase: effect—green tea (large amounts), guarana
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Extracted information for terbutaline only.
DOSAGE AND ROUTES Asthma maintenance • Adult/adolescent ≥16 yr: PO 2.5-5 mg q6h while awake • Child/adolescent 12-15 yr: PO 2.5 mg q6h while awake, max 7.5 mg/day Bronchospasm • Adult/child ≥12 yr: SUBCUT 0.25 mg q15-30min, max 0.5 mg in 4 hr Renal dose • Adult: PO CCr 10-50 mL/min, 50% of dose; CCr <10 mL/min, avoid use Tocolytic (preterm labor) (unlabeled) • Adult: SUBCUT 0.25 mg q20min to 6 hr, hold if pulse >120 bpm
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Available forms: Tabs 2.5, 5 mg; inj 1 mg/mL
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Administer: • With food; may be crushed • 2 hr before bedtime to avoid sleepless- ness IV route (unlabeled) • Only used if subcut is ineffective • IV after diluting each 5 mg/1 L D5W for infusion • IV, run 5 mcg/min; may increase 5 mcg q10min, titrate to response; after 1⁄2-1 hr, taper dose by 5 mcg; switch to PO as soon as possible • Store at room temperature; do not use discolored sol
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Extracted information for terbutaline only.
Assess: • Respiratory function: vital capacity, forced expiratory volume (FEV), ABGs, B/P, pulse, respiratory pattern, lung sounds, sputum before and after treat- ment • CV status: HR/rhythm, chest pain, pal- pitations • CNS: tremors, anxiety, insomnia, dizzi- ness • Tolerance in patients receiving long- term therapy; dose may have to be changed; monitor for rebound broncho- spasm • Paradoxical bronchospasm: dys pnea, wheezing; keep emergency equip ment nearby
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Evaluate: • Therapeutic response: absence of dys- pnea, wheezing
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • Avoid cough/cold/allergy OTC medica- tions because extra stimulation may occur • About all aspects of product; to avoid smoking, smoke-filled rooms, persons with respiratory infections • To maintain adequate hydration; to al- low 15 min between inhalation of prod- uct and inhaled product containing steroid • To take on time; if missed, not to make up after 1 hr; to wait until next dose See Appendix B
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Extracted information for terbutaline only.
PHARMACOKINETICS PO: Onset 1⁄2 hr, peak 1-2 hr, duration 4-8 hr, half-life 3.4 hr SUBCUT: Onset 6-15 min, peak 1⁄2-1 hr, duration 11⁄2-4 hr, half-life 5.7 hr
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Filter the extracted dose blocks for this individual drug.
Asthma maintenance
• Adult/adolescent ≥16 yr: PO 2.5-5 mg q6h while awake
Candidate age grouping · source page 1275
Asthma maintenance
• Child/adolescent 12-15 yr: PO 2.5 mg q6h while awake, max 7.5 mg/day Bronchospasm
Candidate age grouping · source page 1275
Asthma maintenance
• Adult/child ≥12 yr: SUBCUT 0.25 mg q15-30min, max 0.5 mg in 4 hr Renal dose
Candidate age grouping · source page 1275
Asthma maintenance
• Adult: PO CCr 10-50 mL/min, 50% of dose; CCr <10 mL/min, avoid use Tocolytic (preterm labor) (unlabeled)
Candidate age grouping · source page 1275
Asthma maintenance
• Adult: SUBCUT 0.25 mg q20min to 6 hr, hold if pulse >120 bpm
Candidate age grouping · source page 1275