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RESPIRATORY SYSTEM › DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES › ADRENERGICS FOR SYSTEMIC USE › Selective beta-2-adrenoreceptor agonists
terbutaline
R03CC03
Forms & Strengths
- Tablet: 2.5 mg, 5 mg
- Injection: 1 mg/mL in 1 mL ampuls
Adult Dosing
- Bronchospasm: 2.5 mg to 5 mg orally every 8 hours, max 15 mg per 24 hours
- Subcutaneous: 0.25 mg injected into the lateral deltoid area; may repeat in 15-30 minutes, max 0.5 mg in 4 hours
Pediatric Dosing
- Children 12 years and older: 2.5 mg to 5 mg orally every 8 hours, max 15 mg per 24 hours
- Children under 12 years: Safety and efficacy not well established; clinical practice uses 0.05 mg/kg/dose orally every 8 hours, titrating up to 0.15 mg/kg/dose
Indications
- Management of asthma and reversible bronchospasm associated with bronchitis and emphysema
Mechanism of Action
- Selective beta-2 adrenergic receptor agonist that stimulates adenyl cyclase, increasing intracellular cyclic AMP, leading to relaxation of bronchial smooth muscle and inhibition of immediate hypersensitivity mediator release
Contraindications
- Hypersensitivity to terbutaline or any component of the formulation
- Previous use for prolonged tocolysis (Black Box Warning against oral or prolonged IV use for preterm labor due to maternal cardiac risks)
Adverse Reactions
- Nervousness, tremor
- Headache, dizziness
- Tachycardia, palpitations, increased blood pressure
- Hypokalemia, hyperglycemia
- Nausea, vomiting
Drug Interactions
- Other sympathomimetic agents: May potentiate cardiovascular adverse effects
- Beta-blockers: Non-selective beta-blockers antagonize the bronchodilating effect of terbutaline and may induce severe bronchospasm
- Loop or thiazide diuretics: May potentiate ECG changes and/or hypokalemia with acute high-dose beta-agonists
- MAO inhibitors and tricyclic antidepressants: Potentiate vascular effects on the cardiovascular system
Curated Content: Needs Vetting Before Put to Clinical Use