Terbutaline and Magnesium Sulfate

Terbutaline (Brethine), Magnesium Sulfate

Terbutaline (Brethine) Classification

Sympathetic bronchodilator

Terbutaline (Brethine) Mechanism of Action

Beta 2 adrenergic agonist. Relaxes smooth muscles and suppresses preterm labor

Terbutaline (Brethine) Indications

Bronchospasm: asthma, bronchitis, emphysema. Preterm labor

Terbutaline (Brethine) Contraindications

Hypersensitivity, Tachyarrhythmias

Terbutaline (Brethine) Supply

1 mg/mL vial/ampoule

Terbutaline (Brethine) Adminstration Adults

Adult: 0.25 mg SC every 15- 30 min to max dose of 0.5 mg in 4 hours

Terbutaline (Brethine) Adminstration Peds

Peds: 0.01 mg/kg SC every 15-20 mins to max dose of 0.25 mg (not in children under 12 y/o)

Terbutaline (Brethine) Special Considerations

Caution with underlying cardiovascular disease of hypertension

Magnesium Sulfate Classification

Electrolyte

Magnesium Sulfate Mechanism of Action

Reduces striated muscle contractions by reducing Ach release at the myoneural junction

Can cause bronchodilation after beta-agonists/anti-cholinergics

Magnesium Sulfate Indications

Pre-eclampsia, seizures from eclampsia, Torsades de Pointes, V-Fib/pV-Tach refractory to amiodarone

Magnesium Sulfate Contraindications

Heart block, myocardial damage, hypercalcemia

Magnesium Sulfate Supply

1g in 2mL, 5g in 10mL, 25g in 50mL (50% solution) vials. Dilute to 10% solution

Magnesium Sulfate Administration Adults

Pre-eclampsia is 4g of 20% solution IV/IO over 20 min for HTN lasting longer than 15 min with symptoms

Eclampsia is 4g of 50% solution IV/IO over 10-20 min for seizures

Torsades de Pointes is 1-2g of NS solution IV/IO over 5-60 min

Status Asthmaticus is 1-2g IV/IO over 15-30 min. Pending respiratory failure is 40mg/kg IV over 10-15 min. Max dose is 2g

Magnesium Sulfate Administration Peds

Torsades de Pointes is 25-50 mg/kg IV/IO bolus of a 50% solution. Max dose is 2g

Status Asthmaticus is 25-50 mg/kg IV/IO of a 50% solution over 15-30 min. Max dose 2g