From the Guidelines
Bricanyl (terbutaline) is not recommended for heart block and should be avoided in this condition. Terbutaline is a beta-2 adrenergic agonist primarily used to treat asthma and prevent premature labor, not cardiac conduction disorders. For heart block, appropriate treatments include temporary pacing, permanent pacemaker implantation, or medications like atropine or isoproterenol in emergency situations, as outlined in the 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay 1. Using Bricanyl in heart block could potentially worsen the patient's condition as it may cause tachycardia and other cardiac side effects that could be dangerous in someone with existing conduction abnormalities. The drug works by stimulating beta-2 receptors, primarily affecting smooth muscle in the bronchial tree and uterus, not the cardiac conduction system.
Some key points to consider in the management of heart block include:
- Symptomatic sinus bradycardia or atrioventricular block can be treated with atropine, dopamine, isoproterenol, or epinephrine, depending on the severity and underlying cause of the condition 1.
- Second- or third-degree atrioventricular block associated with acute inferior MI may require treatment with aminophylline or other medications to stabilize the heart rhythm.
- Calcium channel blocker overdose can be treated with calcium chloride or calcium gluconate, among other options 1.
- Beta-blocker or calcium channel blocker overdose may require treatment with glucagon or high-dose insulin therapy, depending on the specific circumstances 1.
If you're dealing with a heart block, you should seek immediate medical attention for proper evaluation and treatment by a cardiologist, as heart block can progress and become life-threatening if not managed appropriately.
From the Research
Bricanyl and Heart Block
- Bricanyl, also known as terbutaline, is a beta 2-adrenoceptor agonist used as a bronchodilator for the treatment of asthma and COPD 2, 3.
- There is no direct evidence in the provided studies that Bricanyl is used to treat heart block.
- However, studies have shown that beta 2-adrenoceptor agonists like terbutaline can have positive inotropic effects on the heart, increasing contractility and heart rate 4, 5.
- The use of beta 2-adrenoceptor agonists like terbutaline may be beneficial in certain cardiac conditions, but its effects on heart block are not well established 5.
- Systemic diseases can cause heart block, and underlying conditions should be evaluated in patients with heart block, especially in younger patients [<60] 6.
- The treatment of heart block typically involves addressing the underlying cause, and the use of beta 2-adrenoceptor agonists like Bricanyl is not a standard treatment for heart block.