Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: Brethine (Note: Bricanyl is no longer available in the U.S.)
DRUG CLASS AND MECHANISM: Terbutaline is a member of a class of drugs called
beta adrenergic receptor agonists (stimulators) that is used for treating asthma
and other airway diseases. Other drugs in the same class of drugs include
albuterol (Proventil),
metaproterenol (Alupent), pirbuterol (Maxair), and salmeterol
(Serevent).
Asthma is a breathing problem caused by narrowing of air passages
(bronchial tubes) through which air moves in and out of the lungs. These airways
can be narrowed due to the accumulation of mucus, spasm of the muscles that
surround them (bronchospasm), or swelling of their linings due to the
accumulation of fluid. Airway narrowing leads to shortness of breath, wheezing,
and cough. Terbutaline is a bronchodilator, a medication that dilates (expands)
air passages in the lungs. It attaches to beta adrenergic receptors on muscles
surrounding the air passages, causing the muscles to relax and dilate the air
passages. Wider air passages allow more air to flow in and out of the lungs.
Increased airflow reduces shortness of breath, wheezing, and cough. Terbutaline
also is used for delaying premature labor by relaxing the muscles of the uterus
that are responsible for expelling the fetus at delivery. The FDA approved
terbutaline in 1974.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 2.5 and 5 mg. Injection: 1 mg/ml.
STORAGE: Tablets and injection should be stored at room temperature, 15-30 C
(59-86 F).
PRESCRIBED FOR: Terbutaline is used to relieve and prevent bronchospasms
caused by asthma, emphysema or bronchitis. It is also used for preventing
preterm labor.
DOSING: The recommended adult oral dose for treating asthma, emphysema or
bronchitis is 2.5-5 mg 3 times daily approximately 6 hours apart while awake.
The maximum dosage is 15 mg/day. The recommended subcutaneous (under skin) dose
is 0.25 mg every 15-30 minutes for two doses. The maximum dose is 0.5 mg within
4 hours.
DRUG INTERACTIONS: Combining terbutaline with
thioridazine (Mellaril) may
increase the occurrence of abnormal heart rhythms because both drugs can cause
abnormal heart rhythms.
The effects of terbutaline (a beta stimulant) are reversed by
beta-blockers, for
example, atenolol (Tenormin), nadolol (Corgard), propranolol (Inderal), and
metoprolol (Lopressor). Conversely, terbutaline may reduce the effect of
beta-blockers. Therefore, terbutaline and beta-blockers should not be used
together.
PREGNANCY: Terbutaline reduces uterine contractions and may inhibit labor.
There are no adequate studies of terbutaline in
pregnant women.
NURSING MOTHERS: Terbutaline is found in small amounts in the breast milk of
nursing women. The American Academy of Pediatrics considers terbutaline to be
compatible with breastfeeding.
SIDE EFFECTS: Terbutaline may cause side effects such as tremor, nausea,
nervousness, dizziness, headache, drowsiness,
heartburn, heart palpitations,
fast heart rate, and elevated blood pressure. Nausea,
vomiting, anxiety,
restlessness, lethargy, excessive sweating, chest pain, and muscle cramping also
may occur. Low blood potassium and high blood glucose have been associated with
terbutaline.
Bronchitis is a disease of the respiratory system in which the bronchial passages become inflamed. There are two types of bronchitis, acute and chronic. Symptoms of acute bronchitis include frequent cough with mucus, lack of energy, wheezing, and possible fever. Treatment may require medication such as bronchial inhalers and predinsone. Supportive treatment is focused on relieving the symptoms with fever reducers, cough suppressants, and rest. Treatment may be more aggressive in patients with pre-existing conditions such as empyema, COPD, or cigarette smoking.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
Patients who have infrequent, mild bouts of asthma attacks may use over-the-counter (OTC) medications to treat their asthma symptoms. OTC asthma medicines are limited to epinephrine and ephedrine. These OTC drugs are best used with the guidance of a physician, as there may be side effects and the drugs may not be very effective.
Asthma, the main cause of chronic illness in children, has signs and symptoms in children that include frequent coughing spells, low energy while playing, complaints of chest "hurting," wheezing while breathing, shortness of breath, and feelings of tiredness. Treatment will involve a doctor creating an asthma action plan which will describe the use of asthma medications and when to seek emergency care for the child.
There are many unusual symptoms of asthma, including sighing, difficulty sleeping, anxiety, chronic cough, recurrent walking pneumonia, and rapid breathing. These symptoms may vary from individual to individual. These asthma complexities make it difficult to accurately diagnose and treat asthma.
There are two types of asthma medications: long-term control with anti-inflammatory drugs and quick relief from bronchodilators. Asthma medicines may be inhaled using a metered dose inhaler or nebulizer or they may be taken orally. People with high blood pressure, diabetes, thyroid disease, or heart disease shouldn't take OTC drugs like Primatene Mist and Bronkaid.
Chronic obstructive pulmonary disease (COPD) is comprised primarily of three related conditions - chronic bronchitis,
chronic asthma, and
emphysema. In each condition there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and may be progressive over time.
While asthma features obstruction to the flow of air out of the lungs, usually, the obstruction is reversible. Between "attacks" of asthma the flow of air through the airways typically is normal. These patients do not have COPD. However, if asthma is left untreated, the chronic inflammation associated with this disease can cause the airway obstruction to become fixed. That is, between attacks, the asthmatic patient may then have abnormal air flow. This process is referred to as lung remodeling. These asthma patients with a fixed component of airway obstruction are also considered to have COPD.
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