TERBUTALINE

GENERIC NAME: Terbutaline sulphate

PHARMACOLOGICAL CLASS: Beta 2 adrenergic agonist
ATC CODE: R03AC03
PRACTICE INSIGHTS:

Oral terbutaline should not be used for prevention or any treatment of preterm
labor because efficacy has not been established and safety concerns similar to
IV administration exist

Death and serious adverse reactions have been reported following prolonged
administration of oral or injectable terbutaline to pregnant women

Serious events following prolonged use include tachycardia, transient

hyperglycemia, hypokalemia, arrhythmias, pulmonary edema, and myocardial
ischemia

DOSE
ADULT:
Bronchospasm
Oral

Initiate at 2.5 mg q3-4

Maintenance: 5 mgthree times daily every 6hr while patient is awake; reduce
dose to 2.5 mg every6hr
Not to exceed 15 mg/Day
Subcutaneous

0.25 mg every15-30min x 3 doses PRN in lateral deltoid

Not to exceed 0.5 mg/4
Asthma Acute
Inhalation aerosol

2 inhalations separated by 60 seconds every 4 to 6 hours

Asthma Maintenance
Oral

5mg , 6 hrs interval three times a day

PEDIATRIC:
BRONCHOSPASM

ORAL

<12 years: 0.05 mg/kg three times daily initially

Maximum dose 5 mg/day

12-15 years: 2.5 mg every 6hr 3 times daily; not to exceed 7.5 mg/day
>15 years: 5 mg/dose every 8hr three times daily; reduce dose to 2.5 mg every
6hr; not to exceed 15 mg/24hr

SC (in lateral deltoid)

<12 years: 0.005-0.01 mg/kg (no more than 0.4 mg) every 15-20min x 3; THEN
every 2-6hour PRN

>12 years: 0.25 mg every 15-30min x 3 doses PRN in lateral deltoid; not to
exceed 0.5 mg/4 hr
Asthma Acute
Subcutaneous Injection:

0.005 to 0.01 mg/kg/dose to a maximum dose of 0.4 mg every 15 to 20 minutes

for 2 doses.

DOSE ADJUSTMENT
Hepatic impairment

No dosage adjustment necessary

Renal impairment

GFR <50 mL/min: reduce dose by 50%

GFR >50mL/min: Dose adjustment not necessary

INDICATIONS (OPTIONAL):

Premature labor

PREGNANCY & LACTATION:

Category C
Excretion in breast milk, use with caution if benefits outweigh risks..

MODE OF ACTION: It Relaxes bronchial smooth muscle by stimulating beta2adrenergic receptors; inhibits release of hypersensitivitymediators, especially from ma
st cells
ADVERSE DRUG REACTIONS:
Frequency not defined

Nervousness, restlessness, transient hyperglycemia, transient hypokalemia,

trembling, tachycardia, htn, dizziness, light headedness, drowsiness

DRUG INTERACTIONS:
CONTRAINDICATIONS & WARNINGS:

Contraindicated in
o Prolonged Tocolysis
o Hypersensitivity
Use cautiously in
o Cardiac arrhythmias
o Coronary insufficiency,
o Hypertension
o Hyperthyroidism
o Diabetes mellitus
o Seizure disorders
o Glaucoma

IETARY & GENERAL CONSIDERATIONS:

Tell patient he may take with or without food

.Advise patient or parents to establish effective bedtime routine to
minimize insomnia.
Instruct patient or parents to space doses evenly during waking hours, to
avoid taking drug at bedtime.

MONITORING PARAMETERS:

Monitor:
o CBC with differential, Vitals
o Pulmonary function