Home Drug Guide Terbutaline Sulfate

Drug Guide

Generic Name

Terbutaline Sulfate

Brand Names Bricanyl, Brethine, Brethaire

Classification

Therapeutic: Bronchodilator

Pharmacological: Beta-2 Adrenergic Agonist

FDA Approved Indications

Prevention and relief of bronchospasm in conditions such as asthma, bronchitis, and emphysema; Off-label use for preterm labor to inhibit uterine contractions

Mechanism of Action

Terbutaline stimulates beta-2 adrenergic receptors on bronchial smooth muscle, leading to relaxation of airway muscles and bronchodilation.

Dosage and Administration

Adult: Inhalation: 0.5 mg every 20 minutes up to 3 doses, then as needed. Subcutaneous: 0.25 mg, may repeat every 15-30 minutes as needed up to 4 times.

Pediatric: Inhalation: Dose varies by age and weight. Subcutaneous: typically 0.01 mg/kg, may repeat as needed.

Geriatric: Use with caution; start with lower doses due to increased risk of cardiovascular side effects.

Renal Impairment: Use with caution; monitor for efficacy and adverse effects.

Hepatic Impairment: No specific adjustments established.

Pharmacokinetics

Absorption: Rapid absorption via inhalation and subcutaneous routes.

Distribution: Widely distributed throughout the body, crosses the placenta.

Metabolism: Metabolized minimally in the liver.

Excretion: Primarily excreted unchanged in urine.

Half Life: 3 to 4 hours.

Contraindications

Hypersensitivity to terbutaline or other sympathomimetics.
Cardiac arrhythmias.

Precautions

Use cautiously in patients with cardiovascular disorders, diabetes, hyperthyroidism, or seizure disorders.

Adverse Reactions - Common

Tremor (Common)
Nervousness (Common)
Palpitations (Common)
Tachycardia (Common)
Headache (Common)

Adverse Reactions - Serious

Cardiac arrhythmias (Rare)
Hypokalemia (Rare)
Hyperglycemia (Rare)

Drug-Drug Interactions

Beta-blockers (may diminish efficacy), other sympathomimetics, MAO inhibitors, tricyclic antidepressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, cardiovascular status, blood glucose in diabetics, potassium levels.

Diagnoses:

Ineffective airway clearance
Risk for cardiovascular complications

Implementation: Administer as prescribed, monitor for adverse effects, educate patient on inhaler use.

Evaluation: Assess improvement in breathing, adverse effects, and need for continued therapy.

Patient/Family Teaching

Use inhaler correctly, avoid triggers, report palpitations, chest pain, or tremors.
Notify healthcare provider if symptoms worsen or if side effects occur.
Follow prescribed dosing regimen precisely.

Special Considerations

Black Box Warnings:

None explicitly for terbutaline when used for asthma, but caution advised in off-label use for preterm labor due to risk of maternal and fetal cardiovascular effects.

Genetic Factors: None established.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, hyperglycemia, tremors, nervousness.

Treatment: Discontinue drug, provide supportive care, monitor cardiac status, correct electrolyte imbalances, administration of beta-blockers cautiously if indicated.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under recommended storage conditions for the duration of the shelf life.