Terbutaline

Provider Level

RN/Paramedic

Class

Beta-2 adrenergic agonist, bronchodilator, tocolytic.

Mechanism of Action

Selectively stimulates beta-2 adrenergic receptors, leading to relaxation of bronchial smooth muscle and uterine smooth muscle with minimal beta-1 (cardiac) effects.

Indications

Severe bronchospasm associated with asthma, COPD, or anaphylaxis that is refractory to standard nebulized therapy. Temporary tocolysis for preterm labor.

Contraindications

Hypersensitivity to the drug or sympathomimetics, severe tachycardia, narrow-angle glaucoma.

Routes

SQ, IV

Onset / Duration

Onset: 5 to 15 minutes for subcutaneous administration. Duration: 1.5 to 4 hours.

Adverse Effects

Tachycardia, palpitations, tremors, anxiety, headache, dizziness, nausea, vomiting, transient hyperglycemia, arrhythmias.

Precautions & Interactions

Use with caution in patients with cardiovascular disease, hypertension, diabetes mellitus, hyperthyroidism, or those with a history of seizures. May cause paradoxical bronchospasm.

Special Considerations

Requires continuous ECG and vital sign monitoring. When used for tocolysis, closely monitor maternal and fetal heart rates. Safety and efficacy in children under 12 years have not been fully established.