Terbutaline

Thông tin thuốc gốc
Chỉ định và Liều dùng
Inhalation/Respiratory
Acute bronchospasm
Adult: As metered-dose powd inhaler: 250-500 mcg as required. Max: 2,000 mcg daily.

Inhalation/Respiratory
Severe bronchospasm
Adult: As 1% nebuliser soln: 2.5-10 mg 2-4 times daily.
Child: <25 kg: 2-5 mg 2-4 times daily; ≥25 kg: 5 mg 2-4 times daily.

Intravenous
Uncomplicated premature labour
Adult: To arrest labour between 22-37 wk of gestation: Initially, 5 mcg/min, w/ increments of 2.5 mcg/min at 20 min intervals until contractions stop. Max: 20 mcg/min. Continue for 1 hr after contractions have ceased, then decrease by 2.5 mcg/min every 20 min to lowest dose that maintains suppression. Max duration: 48 hr.

Oral
Acute bronchospasm
Adult: Initially, 2.5 mg or 3 mg tid, up to 5 mg tid as necessary. As modified-release tab: 5 mg or 7.5 mg bid.
Child: <12 yr Initially, 0.05 mg/kg/dose tid, increase gradually as required. Max: 5 mg/day; 12-15 yr 2.5 mg tid; >15 yr Same as adult dose.

Parenteral
Severe bronchospasm
Adult: 250-500 mcg up to 4 times daily by SC, IM or IV inj, or by IV infusion as a soln containing 3-5 mcg/mL at a rate of 0.5-1 mL/min.
Child: 2-15 yr 0.01 mg/kg. Max: 0.3 mg/dose.
Các sản phẩm có chứa hoạt chất Terbutaline tại Việt Nam?
  • Bricanyl
  • Brinoce
  • Nairet
  • Vinterlin
Cách dùng
May be taken with or without food.
Hướng dẫn pha thuốc
Add 10 mL of terbutaline soln for inj to 40 mL of dextrose 5% if using a syringe pump or to 490 mL of dextrose 5% if syringe pump is not available.
Chống chỉ định
Parenteral: Prolonged (beyond 48-72 hr) or maintenance tocolysis, particularly in outpatient or home setting. PO: Acute or maintenance tocolysis.
Thận trọng
Patient w/ thyrotoxicosis, HTN, DM, ketoacidosis, CV disorders (e.g. ischaemic heart disease), convulsive disorders, coronary insufficiency or associated arrhythmias. Childn. Pregnancy and lactation.
Tác dụng không mong muốn
Tachycardia, nervousness, tremor, palpitations, dizziness, headache, nausea, vomiting, anxiety, restlessness, lethargy, drowsiness, weakness, flushes, sweating, chest discomfort, muscle cramps, tinnitus. Rarely, seizures, hypersensitivity vasculitis, elevated liver enzymes.
Potentially Fatal: Increased heart rate, transient hyperglycaemia, hypokalaemia, cardiac arrhythmias, pulmonary oedema, myocardial ischaemia.
Inhalation/Respiratory/IV/Parenteral/PO/SC: C
Chỉ số theo dõi
Monitor cardiorespiratory function, serum K and glucose levels; signs/symptoms of pulmonary oedema (when used in premature labour).
Quá liều
Symptoms: Headache, anxiety, tremor, nausea, tonic cramps, palpitations, tachycardia, arrhythmia; hypotension, hypokalaemia, hyperglycaemia and lactic acidosis may occur. Management: Reduce dose in mild to moderate cases. In severe cases, perform necessary tests to determine acid-base balance, blood sugar and electrolyte levels. Monitor BP, heart rate and rhythm and correct metabolic changes. A cardioselective β-blocker (e.g. metoprolol) may be given for the treatment of arrhythmias but w/ caution.
Tương tác
Increased risk of haemorrhage and serious ventricular rhythm disorder w/ halogenated anaesth. May reduce the effect of anti-diabetic drugs. Increased risk of hypokalaemia w/ K-depleting agents (e.g. diuretics). Concomitant β-agonist and corticosteroid may result to pulmonary oedema. May partially or totally inhibit the effect of non-selective β-blockers.
Tác dụng
Description:
Mechanism of Action: Terbutaline stimulates intracellular adenyl cyclase, the enzyme that catalyses the conversion of ATP to cyclic-3', 5'-adenosine monophosphate (cAMP) resulting in relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from mast cells.
Onset: W/in 5 min (inhalation); 30-45 min (oral); 6-15 min (SC).
Duration: 6 hr (inhalation); 8 hr (oral).
Pharmacokinetics:
Absorption: Variably absorbed from the GI tract; absorbed from the airways (<10%). Bioavailability: Approx 14-15% (oral). Time to peak plasma concentration: 1-4 hr.
Distribution: Crosses the placenta and enters breast milk (trace amounts). Plasma protein binding: 25%.
Metabolism: Undergoes extensive first-pass metabolism via sulfate and some glucoronide conjugation in the liver and the gut wall.
Excretion: Via urine and faeces as inactive sulfate conjugate and unchanged drug. Terminal half-life: 16-20 hr.
Đặc tính

Chemical Structure Image
Terbutaline

Source: National Center for Biotechnology Information. PubChem Database. Terbutaline, CID=5403, https://pubchem.ncbi.nlm.nih.gov/compound/Terbutaline (accessed on Jan. 23, 2020)

Bảo quản
Store between 20-25°C. Protect from light.
Phân loại MIMS
Thuốc trị hen & bệnh phổi tắc nghẽn mạn tính
Phân loại ATC
R03CC03 - terbutaline ; Belongs to the class of adrenergics for systemic use, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
R03AC03 - terbutaline ; Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
Tài liệu tham khảo
Anon. Terbutaline. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/07/2015.

Buckingham R (ed). Terbutaline Sulfate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/07/2015.

McEvoy GK, Snow EK, Miller J et al (eds). Terbutaline Sulfate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 15/07/2015.

Terbutaline Sulfate Tablet (Marlex Pharmaceuticals Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/07/2015.

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