TERBULIN
TERBUTALINE · by BRYON
Composition
Inj: Per ml: Terbutaline sulphate 0.5 mg; amp. Syp: Per ml: Terbutaline sulphate 0.3 mg. Tab: Terbutaline sulphate 2.5 mg.
Indications & Dosage
Asthma, conditions associated with reversible airways obstruction: ORAL: Adult: Initially 2.5 mg tab 3 times a day for 1-2 weeks, thenincreased to up to 5 mg 3 times a day. Children 7-15 yr: 2.5 mg tab 2 or 3 times daily Children 3-7 yr: 2.5-5 ml syrup 8 hourly; 7-15 yr: 5-10 ml syrup 8 hourly. BY SC INJ, OR BY SLOW IV INJ: Adult: 250-500 mcg up to 4 times a day, use in severe cases where oral therapy is inappropriate or ineffective. BY CONT.IV INF: Adult: 90-300 mcg/hour for 8-10 hours, to be administered as a solution containing 3-5 mcg/ml, high doses require close monitoring, use in severe cases where oral therapy is inappropriate or ineffective. Acute asthma: ORAL: Adults: 2.5 mg-5 mg tab 2 or 3 times daily or 10-15 ml syrup 8 hourly. Children 7-15 yr: 2.5 mg tab 2 or 3 times daily. Children 3-7 yr: 2.5-5 ml syrup 8 hourly; 7-15 yr: 5-10 ml syrup 8 hourly. BY SC INJ, OR BY SLOW IV INJ: Children 2-14 yrs: 10 mcg/kg up to 4 times a day(max. per dose 300 mcg); 15-17 years: 250-500 mcg up to 4 times aday, use in severe cases where oral therapy is inappropriate or ineffective. BY CONT.IV INF: Children: Loading dose 2-4 mcg/kg, then1-10 mcg/kg/hour, dose to be adjusted according to response and heart rate, close monitoring is required for doses above 10 mcg/kg/hour, use in severe cases where oral therapy is inappropriate or uneffective. Exacerbation of reversible airways obstruction (including nocturnal asthma), Prevention of exercise-induced bronchospasm: ORAL: Children 1 month-6 yrs: 75 mcg/kg 3 times a day (max. per dose 2.5 mg); 7-14 years: 2.5 mg 2-3 times a day; 15-17 years: Initially 2.5 mg 3 times a day, then increased if necessary to 5 mg 3 times a day. Uncomplicated premature labour: BY IV INF: Adult: Initially 5 mcg/minute for 20 minutes, then increased in steps of 2.5 mcg/minute every 20 minutes until contractions have ceased (more than 10 mcg/minute should seldom be given; should not be exceeded 20 mcg/minute), continue for 1 hour, then reduced in steps of 2.5 mcg/minute every 20 minutes to lowest dose that maintains suppression (max. total duration 48 hours).
Administration
Administered by SC only, usually into the lateral deltoid area.
Compatibility
Dextrose 5%, NaCI 0.45%, 0.9%.
Stability
Store at controlled room temperature and protect from light and freezing.
Contraindications
When used for uncomplicated premature labour: Abruptio-placenta, antepartum haemorrhage, cord compression, eclampsia, history of cardiac disease, intra-uterine infection or fetal death, placenta praevia, pulmonary hypertension, severe pre-eclampsia, risk factors for myocardial ischaemia, threatened miscarriage
Precautions
Mild to moderate pre-eclampsia, suspected cardiovascular disease, myocardial insufficiency, angina, cardiac arrhythmias, hypertension, hyperthyroidism, young children
Interactions
Sympathomimetics, beta-blockers, hypokalaemic agents.
Pregnancy
Caution advised
Lactation
Caution advised
Side Effects
Muscle tension, nausea, pulmonary oedema (with injection use) vomiting, tremor, peripheral vasodilation, tension, headache, sleep and behavioural disturbances in children.