Terbutaline (Brethine, Brethaire, Bricanyl)

Category:

• Respiratory

Description:

• Antiasthmatic, bronchodilator, tocolytic

Indications:

• Bronchospasm (asthma, COPD)

• Premature labor (not FDA approved indication)

Precautions:

• Pregnancy category B; compatible with breast feeding

• Cardiac disorders, hyperthyroidism, diabetes mellitus, prostatic hypertrophy

• Elderly, hypertensive, glaucoma

Adverse Reactions (Side Effects):

• CNS: anxiety, dizziness, headache, insomnia, nervousness, shakiness, tremor

• CV: angina, cardiac arrest, dysrhythmias, hypertension, palpitations, tachycardia

• GI: elevated liver enzymes, nausea, vomiting

Dosage:

Administered via inhalation, subcutaneously, intravenously, and orally

• Adult: 

  • Bronchospasm: 

    • INH 2 puffs separated by 1 minute every 4-6 hours

    • PO 2.5-5mg every 8 hours to max 15mg daily

    • SC 0.25mg, may repeat once in 15-30 minutes

  • Premature labor: 

    • SC 0.25mg every hour

    • IV INF 0.01 mg/min, titrate upward to max of 0.08 mg/min; maintain at minimum effective dose for 4 hours

    • PO 5mg every 4 hours for 48 hours, then 5mg every 6 hours as maintenance for above doses

• Child:   

  • INH 1-2 puffs every 4-6 hours

  • PO 0.05 mg/kg/dose every 8 hours, increased gradually to 0.15 mg/kg/dose to max daily dose 5mg (<12 years)

  • SC 0.005-0.01 mg/kg/dose to max 0.4 mg/kg/dose every 15-20 minutes for 2 doses