Can terbutaline be given to asthma patients?

From the Guidelines

Terbutaline can be given to asthma patients, but it is not a first-line treatment. It is a short-acting beta-2 agonist (SABA) that works by relaxing the smooth muscles in the airways, helping to relieve bronchospasm and improve breathing. The typical dose for adults is 0.25 mg administered subcutaneously, which can be repeated every 20 minutes for 3 doses 1. For acute asthma attacks, the inhaled form (when available) is preferred for faster relief. Terbutaline is more commonly used for managing preterm labor, but in asthma care, medications like albuterol or salbutamol are generally preferred as first-line rescue therapies. Patients should be aware that terbutaline may cause side effects such as tremors, nervousness, increased heart rate, and headaches. Long-term or frequent use should be avoided as it may lead to tolerance and potentially worsen asthma control over time. Any patient using terbutaline for asthma should be under medical supervision and have a comprehensive asthma management plan.

Some key points to consider when using terbutaline for asthma include:

• The dose and administration route, with subcutaneous administration being an option for acute severe asthma 1
• The potential for side effects, such as increased heart rate and tremors 1
• The importance of medical supervision and a comprehensive asthma management plan 1
• The preference for inhaled forms of beta-2 agonists, such as albuterol or salbutamol, as first-line rescue therapies 1

It's also important to note that there is no proven advantage of systemic therapy, such as terbutaline, over aerosol therapy for asthma exacerbations 1. Therefore, the use of terbutaline should be carefully considered and monitored in the context of a comprehensive asthma management plan.

From the FDA Drug Label

Terbutaline Sulfate Injection, USP is indicated for the prevention and reversal of bronchospasm in patients 12 years of age and older with asthma and reversible bronchospasm associated with bronchitis and emphysema.

WARNINGS Deterioration of Asthma Asthma may deteriorate acutely over a period of hours or chronically over several days or longer. If the patient needs more doses of terbutaline than usual, this may be a marker of destabilization of asthma and requires reevaluation of the patient and treatment regimen, giving special consideration to the possible need for anti-inflammatory treatment, e.g., corticosteroids.

Yes, terbutaline can be given to asthma patients, as it is indicated for the prevention and reversal of bronchospasm in patients with asthma 2. However, it should be used with caution and consideration of the potential for deterioration of asthma and cardiovascular effects 3. Key points to consider include:

• Asthma destabilization: increased need for terbutaline may indicate destabilization of asthma, requiring reevaluation and possible addition of anti-inflammatory treatment
• Cardiovascular effects: terbutaline can produce significant cardiovascular effects, and should be used with caution in patients with cardiovascular disorders
• Concomitant treatment: consideration should be given to adding anti-inflammatory agents, such as corticosteroids, to control asthma 3

From the Research

Administration of Terbutaline to Asthma Patients

• Terbutaline can be given to asthma patients as it has been shown to be an effective bronchodilator drug in subjects with acute asthma 4.
• The drug can be administered through various routes, including subcutaneously 4, 5, intravenously 6, 7, 8, and inhalation 8.
• Studies have demonstrated that terbutaline can provide significant bronchodilatation in asthma patients, with improvements in lung function and symptoms 4, 5, 8.

Efficacy and Safety

• The efficacy of terbutaline in asthma patients has been established, with studies showing significant improvements in symptoms and lung function 4, 7, 5.
• However, terbutaline can cause side effects, including tachycardia, which is a consistent finding when subcutaneous doses exceed 0.25 mg 4.
• Continuous terbutaline infusion has been shown to reduce hospital admissions and oral corticosteroid use in patients with severe unstable asthma, but it is associated with significant side effects 7.

Comparison of Administration Routes

• Inhaled terbutaline has been shown to be as effective as intravenous administration in acute severe asthma, with no difference in side effects 8.
• Subcutaneous administration of terbutaline has also been effective in treating status asthmaticus, with significant improvements in symptoms and lung function 5.
• Intravenous terbutaline infusion has been used in severe asthma, but its use should be limited to centers with necessary expertise due to the risk of side effects 7.