Home Drug Guide Terbutaline Sulfate

Drug Guide

Generic Name

Terbutaline Sulfate

Brand Names Bricanyl, Brethine, Brethaire

Classification

Therapeutic: Bronchodilator

Pharmacological: Beta-2 Adrenergic Agonist

FDA Approved Indications

  • Prevention and relief of bronchospasm in conditions such as asthma, bronchitis, and emphysema; Off-label use for preterm labor to inhibit uterine contractions

Mechanism of Action

Terbutaline stimulates beta-2 adrenergic receptors on bronchial smooth muscle, leading to relaxation of airway muscles and bronchodilation.

Dosage and Administration

Adult: Inhalation: 0.5 mg every 20 minutes up to 3 doses, then as needed. Subcutaneous: 0.25 mg, may repeat every 15-30 minutes as needed up to 4 times.

Pediatric: Inhalation: Dose varies by age and weight. Subcutaneous: typically 0.01 mg/kg, may repeat as needed.

Geriatric: Use with caution; start with lower doses due to increased risk of cardiovascular side effects.

Renal Impairment: Use with caution; monitor for efficacy and adverse effects.

Hepatic Impairment: No specific adjustments established.

Pharmacokinetics

Absorption: Rapid absorption via inhalation and subcutaneous routes.

Distribution: Widely distributed throughout the body, crosses the placenta.

Metabolism: Metabolized minimally in the liver.

Excretion: Primarily excreted unchanged in urine.

Half Life: 3 to 4 hours.

Contraindications

  • Hypersensitivity to terbutaline or other sympathomimetics.
  • Cardiac arrhythmias.

Precautions

  • Use cautiously in patients with cardiovascular disorders, diabetes, hyperthyroidism, or seizure disorders.

Adverse Reactions - Common

  • Tremor (Common)
  • Nervousness (Common)
  • Palpitations (Common)
  • Tachycardia (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Cardiac arrhythmias (Rare)
  • Hypokalemia (Rare)
  • Hyperglycemia (Rare)

Drug-Drug Interactions

  • Beta-blockers (may diminish efficacy), other sympathomimetics, MAO inhibitors, tricyclic antidepressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, cardiovascular status, blood glucose in diabetics, potassium levels.

Diagnoses:

  • Ineffective airway clearance
  • Risk for cardiovascular complications

Implementation: Administer as prescribed, monitor for adverse effects, educate patient on inhaler use.

Evaluation: Assess improvement in breathing, adverse effects, and need for continued therapy.

Patient/Family Teaching

  • Use inhaler correctly, avoid triggers, report palpitations, chest pain, or tremors.
  • Notify healthcare provider if symptoms worsen or if side effects occur.
  • Follow prescribed dosing regimen precisely.

Special Considerations

Black Box Warnings:

  • None explicitly for terbutaline when used for asthma, but caution advised in off-label use for preterm labor due to risk of maternal and fetal cardiovascular effects.

Genetic Factors: None established.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, hyperglycemia, tremors, nervousness.

Treatment: Discontinue drug, provide supportive care, monitor cardiac status, correct electrolyte imbalances, administration of beta-blockers cautiously if indicated.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under recommended storage conditions for the duration of the shelf life.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.