TERBUTALINE.

PREPARED BY GROUP 2.
🤔 This is what we will be going through.
Generic name
Brand name
Dosage form
Dosage
ADME
Mechanism of action
Therapeutic uses
Side effects
Caution
Drug interaction
Antidote
Some of the basic things about the drug.
• Generic name: Terbutaline sulphate
• Brand name: Brethine, Bricanyl, etc.
• Dosage form: Either subcutaneous injection, slow intravenous
injection or by Oral.
• Dosage:
1. BY MOUTH Adult: Initially 2.5 mg 3 times a day for 1–2 weeks, then increased to
up to 5 mg 3 times a day, use by inhalation preferred over by mouth
2. BY SUBCUTANEOUS INJECTION, OR BY SLOW INTRAVENOUS INJECTION Adult: 250–500
micrograms up to 4 times a day, reserve intravenous beta2 agonists for those in
whom inhaled therapy cannot be used reliably or there is no current effect
ADME:
• Less than 1% of a dose of terbutaline is eliminated in the feces. An
oral dose of terbutaline has an elimination half life of 3.4 hours, while
the subcutaneous dose has an elimination half life of 2.5 hours.
• The average clearance of terbutaline is 3.0 mL/min/Kg.
• Terbutaline is slight less potent bronchodilator, but with fewer
cardiovascular side effects.
• Has a duration of action of 2 – 4 Hours.
Mechanism of Action:
• Terbutaline is a Beta-2 selective agonist bronchodilator.
• It selectively binds to and activates Beta-2 adrenergic receptors
leading to intracellular adenyl cyclase activation via a trimeric G-
protein and subsequent increase in cyclic AMP production.
• cAMP plays a key role in the function of many airway cells including
controlling ciliary beat frequency (critical for mucus clearance) in
airway epithelial cells and suppressing the pro-inflammatory activities
of various immune and inflammatory cells.
Therapeutic uses:
• The drug is used to prevent and relief bronchospasm in patients with
asthma and other lung diseases.
• Also its used to prevent and treat wheezing, shortness of breath and
chest tightness by relaxing and opening the airways, making it easier
to breath.
• It has also been used in selected patients as maintenance of tocolytic
therapy to inhibit uterine contractions for longer periods of time after
an episode of preterm labor has been arrested acutely.
Side effects:

GENERAL SIDE-EFFECTS
• Common or very common: Hypotension
• Rare or very rare :Myocardial ischaemia & vasodilation
• Frequency not known : Angioedema, anxiety, behaviour abnormality,
bronchospasm, circulatory collapse, oral-irritation, sleep disorder, throat
irritation, urticaria.
SPECIFIC SIDE-EFFECTS
• Uncommon: With parenteral use cause Pulmonary oedema
• Rare or very rare: With parenteral use cause Lactic acidosis, Akathisia
and bleeding tendency
Caution:
Mild to moderate pre-eclampsia (when used for
uncomplicated premature labour). suspected
cardiovascular disease (should be assessed by a
cardiologist before initiating therapy for uncomplicated
premature labour)
Drug interaction:
Contraindications:
• When used for uncomplicated • Intra-uterine infection
premature labour abruptio • Placenta praevia
placenta
• Pulmonary hypertension
• Antepartum hemorrhage
• Severe pre-eclampsia
• Cord compression
• Significant risk factors for
• Eclampsia myocardial ischaemia
• History of cardiac disease • Threatened miscarriage
• Intra-uterine fetal death.
Antidote:
• The effects of terbutaline are reversed by beta-blockers such
as Atenolol, Nadolol, Propranolol and Metoprolol.