Obstetrics Book

http://www.fpnotebook.com/

TerbutalineAka: Brethine, Bricanyl

Advertisement

  1. See Also
    1. Preterm Labor Management
    2. Tocolytic
  2. Indications
    1. Preterm Labor
    2. Asthma
  3. Contraindications
    1. Antepartum hemorrhage
    2. Cardiovascular disease
    3. Hyperthyroidism
    4. Uncontrolled Diabetes Mellitus
  4. Dosing: Preterm Labor
    1. Subcutaneous
      1. Dose: 0.25 mg SQ every 1-4 hours for 24 hours
      2. Maximum: 5 mg in 24 hours
    2. Intravenous
      1. Start: 10 mcg/minute
      2. Increase rate by 5 mcg per minute every 10 minutes
      3. Maximum: 25 mcg per minute
      4. Once controlled, decrease dose 5 mcg every 30 minutes
      5. Titrate dose down to lowest effective dose
    3. Oral (not effective)
      1. Dose: 2.5 to 7.5 mg PO every 1.5 to 4 hours
      2. Hold for maternal pulse >100 beats per minute
    4. Subcutaneous Pump
      1. Basal rate: 0.05 to 0.10 mg/hour
      2. Boluses: 0.25 mg
  5. Efficacy
    1. Effective at temporarily stopping contractions
      1. Results in shortest hospital triage stays
      2. Guinn (1997) Am J Obstet Gynecol 177:814
    2. Oral terbutaline is not effective in Preterm Labor
      1. Lewis (1996) Am J Obstet Gynecol 175:834
  6. Adverse Effects
    1. Maternal Tachycardia
    2. Fetal Tachycardia
    3. Tremor
    4. Palpitations
    5. Anxiety
    6. Shortness of Breath
    7. Pulmonary edema
  7. Monitoring
    1. Baseline testing to consider
      1. Electrocardiogram
      2. Serum Glucose
      3. Serum Potassium
      4. Complete Blood Count
      5. Type and screen
    2. Close monitoring
      1. Blood Pressure for Hypertension
      2. Pulse for maternal tachycardia over 100
      3. Lung exam for signs of pulmonary edema
      4. Follow Serum Glucose and Serum Potassium
      5. Consider fluid restriction <2400 cc per day

Terbutaline (C0039542)

Definition (MSH)A selective beta-2 adrenergic agonist used as a bronchodilator and tocolytic.
Definition (CSP)beta-adrenergic receptor agonist used as a bronchodilator and tocolytic.
Definition (NCI)An ethanolamine derivative with bronchodilating and tocolytic activities. Terbutaline selectively binds to and activates beta-2 adrenergic receptors, leading to intracellular adenyl cyclase activation via a trimeric G protein and subsequent increase in cyclic AMP (cAMP) production. Increased cAMP levels result in relaxation of bronchial and vascular smooth muscle mediated through the activation of protein kinase A (PKA), which phosphorylates proteins in control of muscle tone. cAMP also inhibits calcium ion release from intracellular stores, reduces calcium entry into cells and induces the sequestration of intracellular calcium all of which aids in the relaxation of airway muscles. Terbutaline also increases mucociliary clearance and reduces release of inflammatory cell mediators.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD013726
EnglishTerbutaline, TERBUTALINE PREPARATION
Spanishterbutalina
Parent ConceptsEthanolamines (C0014983), Adrenergic Agents (C0001637), Bronchodilator Agents (C0006280), Phenethylamines (C0031399), Adrenergic beta-Agonists (C0001644), [AU100] SYMPATHOMIMETICS (ADRENERGICS) (C0973492), [RE102] BRONCHODILATORS, SYMPATHOMIMETIC,INHALATION (C0973617), [RE103] BRONCHODILATORS, SYMPATHOMIMETIC,ORAL (C0973618), Selective beta-2 adrenoceptor stimulants (C0354671), Respiratory sympathomimetic agent (C1272573), Bronchodilators, Sympathomimetic (C1579392)
SourcesAOD, CSP, LNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Bricanyl (C0591192)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD013726
EnglishAstraZeneca Brand of Terbutaline Sulfate, Bricanyl, Bricanyl SA, Hoechst Brand of Terbutaline Sulfate, pharma-stern Brand of Terbutaline Sulfate, Terbasmin
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Brethine (C0701014)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD013726
EnglishBrethine, Novartis Brand of Terbutaline Sulfate
SourcesMSH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree