Terbutaline (Subcutaneous)

Used to prevent bronchospasms, Terbutaline provides relief to patients with bronchitis, chronic obstructive pulmonary disease (COPD) emphysema, asthma and other respiratory conditions.

Overview

When given subcutaneously, Terbutaline is delivered via injection. Although this medication can also be taken orally, a Terbutaline injection can be more effective for some patients. People who are having trouble breathing due to an established lung or respiratory condition may benefit from Terbutaline injections, for example.

Used as a bronchodilator, Terbutaline relaxes certain muscles in the lungs. Muscles within the bronchial tubes, or air passages, can contract and make breathing difficult. By relaxing these muscles, Terbutaline improves the flow of air to the lungs and enables patients to breathe more easily. As well as relieving troubled breathing, Terbutaline can help to reduce wheezing, coughing and shortness of breath.

In many cases, nurses or other healthcare practitioners will administer a Terbutaline injection. Often delivered in a clinical setting, patients may receive this whilst in hospital or during a consultation with a physician.

Despite being delivered subcutaneously via an injection, patients may be able to administer Terbutaline injections at home too. For patients who are receiving injections regularly and on an on-going basis, it can be more convenient to learn how to self-administer the injections. When using Terbutaline injections at home, however, the patient or their caregiver must be taught how to administer the medication by a doctor or trained medical professional.

Although Terbutaline injections provide effective relief from respiratory symptoms, they are often used in conjunction with other medications. Patients who are prone to asthma attacks may have another, more fast-acting medicine to take in the event of an attack occurring, for example. Often used on a long-term basis, Terbutaline injections can provide on-going relief from symptoms of asthma, bronchitis and emphysema, once an appropriate dosing strategy has been determined.

Conditions Treated

Type of Medicine

  • Bronchodilator

Side Effects

When taking any type of medication, there is a risk of side effects occurring. Some side effects are more serious than others, however, and may require immediate medical attention. If the following side effects occur after receiving a Terbutaline injection, it may indicate too much solution has been administered:

  • Arm, back, or jaw pain
  • Nausea
  • Chest pain
  • Mood changes
  • Confusion
  • Dizziness
  • Seizures
  • Lightheadedness or faintness, particularly when getting up from a sitting or lying position
  • Dry mouth
  • Unusual tiredness or weakness
  • General feeling of discomfort or illness
  • Loss of appetite
  • Increased thirst
  • Headache
  • Chest tightness or heaviness
  • Muscle pain or cramps
  • Blurred vision
  • Vomiting
  • Tingling or numbness in the hands, lips or feet
  • Decreased urinary output
  • Convulsions
  • Inability to sleep
  • Fainting

As the above side effects are associated with excessive doses of Terbutaline, it's important that patients seek medical help urgently if these symptoms occur. If medical attention is sought quickly, physicians may be able to reverse the effects of the medication, thus relieving the associated side effects.

Terbutaline injections can also cause side effects which do not normally warrant an emergency response. Whilst the patient should seek medical help if they experience the following, they do not constitute a life-threatening medical emergency:

  • Wheezing
  • Difficult or labored breathing
  • Shakiness, particularly in the legs, arms, hands, or feet
  • Trembling or shaking of the hands or feet
  • Chest discomfort
  • Nervousness
  • Tightness in chest area
  • Redness of the face, neck, arms, and occasionally, upper chest
  • shortness of breath
  • Sweating
  • Feeling of warmth
  • Fast, irregular, pounding, or racing heartbeat or pulse

In addition to this, patients may experience more mild side effects and these do not usually require immediate medical attention. Drowsiness following the injection is not uncommon, for example, and is not usually problematic. Similarly, patients may experience pain at the site of the injection, weakness and, in rare cases, fever, anxiety, sores, redness, itching and blistering skin.

It's important to remember that not all patients will suffer side effects when receiving Terbutaline injections. Furthermore, patients who do experience side effects may suffer one or two of the above mentioned symptoms, rather than every type of side effect associated with the medicine.

If side effects are debilitating, prolonged or present a medical emergency, it's vital that patients seek help quickly. Whilst mild or moderate side effects can often be managed, more extreme side effects may require medical intervention and may also result in treatment being discontinued. Patients should always seek medical advice before discontinuing treatment.

Dosage

Typically, Terbutaline injections are administered by healthcare practitioners in a clinical setting. When the injection is given by another person, it is normally administered to the shoulder area and is given subcutaneously, rather than intra-muscularly.

Appropriate for use in patients aged 12 or over, a starting dose of 0.25 mg of Terbutaline solution is normally given to prevent bronchospasms. Depending on the patient's medical history and symptoms, the dose may be increased. It is not usual for more than 0.5 mg of Terbutaline solution to be given within a 4 hour period, however.

If Terbutaline injections are prescribed for home-use, the patient must receive thorough instructions from their physician or another healthcare practitioner. Similarly, if a caregiver will be administering the Terbutaline injections, they should receive the appropriate training beforehand.

As well as learning how to administer the Terbutaline injections subcutaneously, patients must be aware of how to prepare the solution. If the patient is unsure how to administer the injection, they should seek medical assistance.

As with most medications, patients will receive specific dosage instructions when they are prescribed Terbutaline injections. Physicians may deviate from the standard dose and they may advise the patient to administer the medication at a specific time each day. Due to this, it's important that patients adhere to the instructions given by their doctor and seek clarification if necessary.

In the event of a missed dose, patients should take the dose they have missed, if it is reasonable to do so. If the next dose is due soon, for example, the patient should skip the missed dose completely and administer the next dose at the normal time. A double dose of Terbutaline should not be given, even if a dose has been missed.

If the patient has missed a Terbutaline injection and is unsure how to continue with treatment, they should contact their doctor or pharmacist for further advice.

Warnings

Terbutaline injections are not usually prescribed in conjunction with Iobenguane I 123. If patients are receiving treatment with Iobenguane I 123, they should inform their physician before they receive Terbutaline injections. Whilst the two drugs are not normally prescribed together, physicians may approve the use of both treatments, if they feel that it is in the best interests of the patient.

Patients who are experiencing other medical issues may not be suitable candidates for treatment with Terbutaline. If the patient has been diagnosed with, or is suspected of having, the following conditions, they should inform their physician:

  • Diabetes or high blood sugar
  • Seizures - Terbutaline may worsen seizures in some instances
  • Heart rhythm problems (e.g., arrhythmia)
  • Hypertension (high blood pressure)
  • Ketoacidosis (high level of ketones in the blood)
  • Hypokalemia (low potassium in the blood)
  • Hyperthyroidism (overactive thyroid)
  • Heart or blood vessel disease

If doctors choose to prescribe Terbutaline injections to a patient with one or more of the above conditions, they may alter the dose in order to reduce the risk of complications occurring. Due to this, it's vital that patients provide their doctor with a full medical history before being prescribed this medication.

Terbutaline injections are only suitable for patients over the age of 12. Children under this age should not, therefore, receive this type of medication and another form of treatment should be sought.

In older or elderly patients, medication may have a stronger effect than usual. In addition to this, elderly patients may be more likely to have heart, kidney and/or liver problems. As a result, physicians will often use a lower starting dose than average when treating older patients and increase the dose gradually, if a higher dose is needed.

Although Terbutaline injections can be given to patients who are pregnant, this course of treatment should only be given if the benefits clearly outweigh the risks posed to the fetus and the mother. In some instances, Terbutaline injections could increase the risk of heart problems if given to a pregnant patient over a long period of time.

If the patient is pregnant or planning to get pregnant, they should discuss this with their doctor. Similarly, if the patient becomes pregnant whilst receiving Terbutaline injections, they should contact their physician.

When breastfeeding mothers receive medication, there is a chance that it could be passed to the infant. Although studies have suggested that Terbutaline presents a minimal risk, it could reach the infant via breastfeeding. Nursing mothers should discuss this with their physician before breastfeeding whilst receiving Terbutaline injections.

Any medication, vitamin and/or herbal supplement can affect the way that medicines work. Patients should, therefore, inform their doctor if they are taking any other medicines, including over-the-counter medications. In addition to this, patients should advise their physician if they consume alcohol, smoke tobacco, use recreational drugs, take any vitamins and/or herbal supplements.

Once receiving Terbutaline injections, patients should seek medical advice before taking any other medications, including over-the-counter medicines. Drugs aimed at resolving hay fever, sinus problems, weight, colds and coughs could be particularly problematic when receiving Terbutaline injections and should be avoided, unless the patient has received medical advice to the contrary.

Before receiving Terbutaline injections, patients should inform their doctor if they have experienced an allergic reaction to associated drugs in the past. Allergies to other bronchodilators, such as Albuterol and/or Metaproterenol, and sympathomimetic drugs, such as Pseudoephedrine and/or Epinephrine may be particularly relevant.

Terbutaline may make patients feel drowsy and/or dizzy. Due to this, patients should refrain from driving and/or operating heavy machinery if they feel unable to do so safely.

Storage

If the patient receives Terbutaline injections in a clinical setting, the storage of the medication will be managed by healthcare professionals. If the patient is prescribed Terbutaline injections for home-use, however, they will need to store the medication and associated paraphernalia in a secure location.

Terbutaline solution is used for subcutaneous treatment and is usually prescribed in single use vials. These should usually be stored at room temperature, away from direct sunlight and heat. Once a vial has been opened, it should be used straight away. If it has been opened in error or cannot be used immediately, it should be disposed of safely.

In order to administer the medication, patients will receive a prescription for syringes and needles. These are normally packed individually and are appropriate for single-use only. Once open, the syringe and needle should be used immediately and then discarded. Under no circumstances should needles and syringes be left around the home, particularly if children and/or pets are present.

Once the injection has been administered, the vial, used syringe and needle should be disposed of carefully. Patients should be given a special container in which to dispose of needles. Often referred to as a 'sharps box', this is a hard, plastic container that needles cannot break or poke through. This container should also be kept in a secure location. Medication, syringes and needles should never be thrown out with household waste. This could present a serious safety hazard to others.

If the patient is advised to discontinue treatment or if the Terbutaline reaches its use-by date, it should be discarded carefully. Patients can seek help from their pharmacist when disposing of medication, sharps boxes and unused syringes and needles.

Summary

Respiratory conditions, such as asthma, COPD and bronchitis, can cause on-going symptoms. As well as periods of acute ill-health, patients may experience mild or moderate symptoms on a near constant basis. Terbutaline injections help to relieve these symptoms and, in many cases, enable patients to perform their daily routine without becoming symptomatic.

As Terbutaline injections allow the muscles in the bronchial tubes to relax, patients should find it much easier to breathe once they begin treatment with this medication. Whilst many patients will need to use additional medication in the event of an acute respiratory issue, such as an asthma attack, Terbutaline injections should help to reduce the frequency of these episodes.

As patients can learn to self-administer Terbutaline injections, it can be a convenient form of treatment. In fact, many patients prefer to use Terbutaline injections at home, rather than attending frequent in-patient appointments. With many people continuing to suffer from chronic respiratory illnesses, Terbutaline injections present a viable and effective form of treatment and symptom management.

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Last Reviewed:
December 24, 2017
Last Updated:
April 27, 2018
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