Pharm
Terbutaline
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Terbutaline
, Brethine, Bricanyl
See Also
Preterm Labor Management
Tocolytic
Indications
Preterm Labor
Asthma
Contraindications
Antepartum
Hemorrhage
Cardiovascular disease
Hyperthyroidism
Uncontrolled
Diabetes Mellitus
Dosing
Preterm Labor
Subcutaneous
Dose: 0.25 mg SQ every 1-4 hours for 24 hours
Maximum: 5 mg in 24 hours
Intravenous
Start: 10 mcg/minute
Increase rate by 5 mcg per minute every 10 minutes
Maximum: 25 mcg per minute
Once controlled, decrease dose 5 mcg every 30 minutes
Titrate dose down to lowest effective dose
Oral (not effective)
Dose: 2.5 to 7.5 mg PO every 1.5 to 4 hours
Hold for maternal pulse >100 beats per minute
Subcutaneous Pump
Basal rate: 0.05 to 0.10 mg/hour
Boluses: 0.25 mg
Efficacy
Effective at temporarily stopping contractions
Results in shortest hospital triage stays
Guinn (1997) Am J Obstet Gynecol 177:814-87 [PubMed]
Oral Terbutaline is not effective in
Preterm Labor
Lewis (1996) Am J Obstet Gynecol 175:834-7 [PubMed]
Adverse Effects
Maternal
Tachycardia
Fetal Tachycardia
Tremor
Palpitation
s
Anxiety
Shortness of Breath
Pulmonary Edema
Monitoring
Baseline testing to consider
Electrocardiogram
Serum Glucose
Serum Potassium
Complete Blood Count
Type and screen
Close monitoring
Blood Pressure
for
Hypertension
Pulse
for maternal
Tachycardia
over 100
Lung Exam
for signs of
Pulmonary Edema
Follow
Serum Glucose
and
Serum Potassium
Consider fluid restriction <2400 cc per day
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