Terbutaline Sulfate

Drug Data

Classification

Generic Name Terbutaline sulfate

Pharmacologic Class Beta2-selective adrenergic antagonist

Trade Name Brethine Minimum Dose 5 mg at 6-hr intervals tid Maximum Dose 15 mg/day

Therapeutic Class Antasthmatic, Bronchodilator, Sympathomimetic , Tocolytic drug Pregnancy Risk Factor B

Contents Terbutaline su lf at e

Mechanism of Action

Indication

Contraindications

In low doses, acts relatively selectively at beta2-adrenergic receptors to cause bronchodilation and relax the pregnant uterus; At higher doses, beta2 selectively is lost and the drug acts at beta1 receptors to cause typical sympathomimetic cardiac effects.

General Indications - Prophylaxis and treatment of bronchial asthma and reversible bronchospasm that may occur with bronchitis and emphysema, in patients 12 yr and older - Unlabeled use: Tocolytic to prevent preterm labor

Concentrations - Hypersensitivity to terbutaline - Tachyarrhythmias, tachycardia caused by digitalis intoxication - General anesthesia with halogenated hydrocarbons or cyclopropane - Unstable vasomotor system disorders - Labor and delivery - Lactation

Pharmacokinetics D: May cross placenta; enters breast milk M: Tissue E: Urine Rout e Oral

Availability and color

SubQ

- Tablets: 2.5, 5 mg - Injection: 1 mg/mL

Onset 30 min 5-15 min

Peak 2-3 hr 30-60 min

Precaution - Diabetes, Coronary insufficiency, CAD, History of CVA, COPD patient, Hyperthyroidism, History of seizure disorder, Psychoneurotic individuals, Hypertension

Duratio n 4-8 hr 1.5-4 hr

Drug Half Life 2-4 hr

Adverse Reaction CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesia, insomnia, tremor, drowsiness, irritability, weakness, vertigo, headache, seizures CV: Cardiac arrhythmias, palpitations, angina pain, changes in BP and ECG GI: Nausea, vomiting, heartburn, unusual or bad taste in mouth Respiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasm Other: Sweating, pallor, flushing, muscle cramps, elevated LFTs

During - Use minimal doses for minimal periods of time, drug tolerance can occur with prolonged use. - Keep a beta-blocker, such as atenolol, readily available in case cardiac dysrhythmias occur. - For oral forms, administer with water to facilitate swallowing. - For parenteral forms, avoid contact with the needle. - Stay with patient throughout whole duration of administration. After - Monitor client for at least 30 minutes. - Arrange for regular follow-up, including blood tests, to evaluate effects. - Instruct to report chest pain, dizziness, insomnia, weakness, tremor or irregular heartbeat, failure to respond to usual dosage. - Instruct to take medication as directed for the full course of therapy, even if feeling better. - Do not double dose. - Do proper documentation.

Drug interaction > Drug to drug - Increased likelihood of cardiac arrhythmias with halogenated hydrocarbon anesthetics - Risk of bronchospasms if combined with diuretics - Increased risk of hypokalemia and ECG changes with MAOIs and TCAs

Routes of administration Oral Subcutaneous

Nursing Responsibilities Before - Observe 15 rights of drug administration. - Reduce dosage with hepatic or renal failure. - Assess for hypersensitivity to drug. - Assess for any contraindications to the drug. - Educate about side effects of drug.

> Drug to food - none reported Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 11251126

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 1125

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 1125-1126

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 1126

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 1126

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 1126

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 1127