Contents
Side Effects of Terbutaline
Terbutaline is a bronchodilator used to treat asthma and other airway diseases.
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Asthma is caused by narrowed air passages (bronchial tubes) through which air moves in and out of the lungs. These airways can narrow due to mucus accumulation, bronchospasm, or fluid accumulation. Narrowed airways cause shortness of breath, wheezing, and coughing.
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Terbutaline expands air passages in the lungs by attaching to beta adrenergic receptors on surrounding muscles. This relaxes and dilates the air passages, allowing for increased airflow. This reduces shortness of breath, wheezing, and coughing.
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Terbutaline is also used to delay premature labor by relaxing the uterine muscles responsible for expelling the fetus during delivery.
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Common side effects of terbutaline include:
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- tremor,
- nausea,
- nervousness,
- dizziness,
- headache,
- drowsiness,
- heartburn,
- heart palpitations,
- fast heart rate, and
- elevated blood pressure.
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Serious side effects of terbutaline include:
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- vomiting,
- anxiety,
- restlessness,
- lethargy,
- excessive sweating,
- chest pain, and
- muscle cramping.
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Low blood potassium (hypokalemia) and high blood glucose have been associated with terbutaline use.
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Terbutaline may interact with thioridazine, increasing the risk of abnormal heart rhythms. Its effects are reversed by beta-blockers and may reduce the effects of beta-blockers. Terbutaline reduces uterine contractions and may inhibit labor. There are no adequate studies on its effects in pregnant women.
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Terbutaline is found in small amounts in the breast milk of nursing women. The American Academy of Pediatrics considers it compatible with breastfeeding.
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Important Side Effects of Terbutaline
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Side effects of terbutaline include:
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- tremor,
- nausea,
- nervousness,
- dizziness,
- headache,
- drowsiness,
- heartburn,
- heart palpitations,
- fast heart rate, and
- elevated blood pressure.
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Vomiting, anxiety, restlessness, lethargy, excessive sweating, chest pain, and muscle cramping can also occur. Low blood potassium (hypokalemia) and high blood glucose have been associated with terbutaline use.
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Terbutaline Side Effects for Healthcare Professionals
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The adverse reactions observed with terbutaline are similar to those seen with other sympathomimetic agents. These reactions are transient and usually do not require treatment.
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The following table compares the incidence of adverse reactions in patients treated with terbutaline sulfate injection (0.25 mg and 0.5 mg) and epinephrine injection (0.25 mg and 0.5 mg) during eight double-blind crossover studies involving 214 patients:
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Incidence (%) of Adverse Reactions
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| Terbutaline (%) | Epinephrine (%) | |||
| 0.25 mg | 0.5 mg | 0.25 mg | 0.5 mg | |
| N=77 | N=205 | N=153 | N=61 | |
| Reaction | ||||
| Central Nervous System | ||||
| Tremor | 7.8 | 38.0 | 16.3 | 18.0 |
| Nervousness | 16.9 | 30.7 | 8.5 | 31.1 |
| Dizziness | 1.3 | 10.2 | 7.8 | 3.3 |
| Headache | 7.8 | 8.8 | 3.3 | 9.8 |
| Drowsiness | 11.7 | 9.8 | 14.4 | 8.2 |
| Cardiovascular | ||||
| Palpitations | 7.8 | 22.9 | 7.8 | 29.5 |
| Tachycardia | 1.3 | 1.5 | 2.6 | 0.0 |
| Respiratory | ||||
| Dyspnea | 0.0 | 2.0 | 2.0 | 0.0 |
| Chest discomfort | 1.3 | 1.5 | 2.6 | 0.0 |
| Gastrointestinal | ||||
| Nausea/vomiting | 1.3 | 3.9 | 1.3 | 11.5 |
| Systemic | ||||
| Weakness | 1.3 | 0.5 | 2.6 | 1.6 |
| Flushed feeling | 0.0 | 2.4 | 1.3 | 0.0 |
| Sweating | 0.0 | 2.4 | 0.0 | 0.0 |
| Pain at injection site | 2.6 | 0.5 | 2.6 | 1.6 |
| Some patients received multiple dosage strengths of terbutaline sulfate and epinephrine. Additionally, anxiety, muscle cramps, and dry mouth often occur ( < 0.5%). Rare reports of elevated liver enzymes and hypersensitivity vasculitis have also been associated with terbutaline. | ||||
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Drug Interactions with Terbutaline
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Concurrent use of terbutaline with other sympathomimetic agents is not recommended due to potential adverse effects on the cardiovascular system.
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Monoamine Oxidase Inhibitors or Tricyclic Antidepressants
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Terbutaline should be used cautiously in patients taking monoamine oxidase inhibitors or tricyclic antidepressants, as its vascular effects may be enhanced.
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Beta-Blockers
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Beta-blockers block the pulmonary effects of beta-agonists like terbutaline and can cause severe bronchospasm in asthmatic patients. Asthmatic patients should not typically be treated with beta-blockers. However, under certain circumstances, cardioselective beta-blockers may be considered with caution, such as after a heart attack.
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Diuretics
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The use of nonpotassium-sparing diuretics (such as loop or thiazide diuretics) can exacerbate the ECG changes and/or hypokalemia caused by beta-agonists, especially with high doses. Caution is advised when coadministering beta-agonists with nonpotassium-sparing diuretics.
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Summary
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Terbutaline is a bronchodilator used to treat asthma and airway diseases. Common side effects include tremor, nausea, nervousness, dizziness, headache, drowsiness, heartburn, heart palpitations, fast heart rate, and elevated blood pressure. Terbutaline reduces uterine contractions and may inhibit labor. Its effects in pregnant women are not sufficiently studied. Terbutaline is found in small amounts in breast milk and is considered compatible with breastfeeding by the American Academy of Pediatrics.
