• Management of reversible airway disease due to asthma (subcut used for short-term control and oral agent as long-term control).

Unlabeled Uses:

• Management of preterm labor (tocolytic) (terbutaline injection may only be used for the short-term [≤72 hr]) management of preterm labor to prolong pregnancy and allow for the administration of antenatal steroids).

Contraindicated in:

• Hypersensitivity to adrenergic amines.

Use Cautiously in:

• Cardiac disease
• Hypertension
• Hyperthyroidism
• Diabetes
• Glaucoma
• OB: Use for bronchodilation in pregnancy only if potential maternal benefit justifies potential fetal risk
• Geri: Older adults are more susceptible to adverse reactions (may require dose ↓).

CV: angina, arrhythmias, hypertension, myocardial ischemia, tachycardia.

Endo: hyperglycemia.

F and E: hypokalemia.

GI: nausea, vomiting.

Neuro: nervousness, restlessness, tremor, headache, insomnia.

Resp: pulmonary edema.

Drug-Drug:

• Concurrent use with other adrenergics (sympathomimetic) will have additive adrenergic side effects.
• Use with MAO inhibitors may lead to hypertensive crisis.
• Beta blockers may negate its therapeutic effect.

Drug-Natural Products:

• Use with caffeine-containing herbs (cola nut, guarana, mate, tea, coffee) ↑ stimulant effect.

(Generic available)

• Tablets: 2.5 mg; 5 mg;
• Solution for injection: 1 mg/mL;

Asthma

• PO (Adults and Children >15 yr): 2.5–5 mg 3 times daily, given every 6 hr (not to exceed 15 mg/24 hr).
• PO (Children 12–15 yr): 2.5 mg 3 times daily (given every 6 hr) (not to exceed 7.5 mg/24 hr).
• PO (Children <12 yr): 0.05 mg/kg 3 times daily; may ↑ gradually (not to exceed 0.15 mg/kg 3–4 times daily or 5 mg/24 hr).
• SC (Adults and Children ≥12 yr): 250 mcg; may repeat in 15–30 min (not to exceed 500 mcg/4 hr).
• SC (Children <12 yr): 0.005–0.01 mg/kg; may repeat in 15–20 min.

Tocolysis (off-label)

• IV (Adults): 2.5–10 mcg/min infusion; ↑ by 5 mcg/min every 10 min until contractions stop (not to exceed 30 mcg/min). After contractions have stopped for 30 min, ↓ infusion rate to lowest effective amount and maintain for 4–8 hr.

• Results in the accumulation of cyclic adenosine monophosphate (cAMP) at beta-adrenergic receptors.
• Produces bronchodilation.
• Inhibits the release of mediators of immediate hypersensitivity reactions from mast cells.
• Relatively selective for beta₂(pulmonary)-adrenergic receptor sites, with less effect on beta₁(cardiac)-adrenergic receptors.

• Bronchodilation.

Therapeutic Classification: bronchodilators

Pharmacologic Classification: adrenergics

Absorption: 35–50% absorbed following oral administration but rapidly undergoes first-pass metabolism. Well absorbed following SUBQ administration.

Distribution: Unknown.

Metabolism/Excretion: Partially metabolized by the liver; 60% excreted unchanged by the kidneys.

Half-life: 5.7 hr.

Bricanyl Turbuhaler

(bronchodilation)

• Instruct patient to take medication as directed. If on a scheduled dosing regimen, take a missed dose as soon as possible; space remaining doses at regular intervals. Do not double doses. Caution patient not to exceed recommended dose; may cause adverse effects, paradoxical bronchospasm, or loss of effectiveness of medication.
  • Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain.
  • Advise patient to consult health care professional before taking any OTC medications or alcoholic beverages concurrently with this therapy. Caution patient also to avoid smoking and other respiratory irritants.
• Preterm Labor: Notify health care professional immediately if labor resumes or if significant side effects occur.

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