Inhibition of Premature Labor by Terbutaline

Wallace, Roger L.; Caldwell, David; Ansbacher, Rudi; Otterson, Warren N.

doi:10.1097/00006250-197804000-00001

Cited by 55 publications

(5 citation statements)

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“…Alternatively, when establishing an upper dosing range, no clear endpoint exists. The upper dose range of terbutaline administered intravenously ranges from 17.5 mg/mL at our institution to 80 μg/mL at other institutions 19 …”

Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

Adverse effects of tocolytic therapy

Caritis

2005

BJOG

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The rationale for using tocolytics in preterm labour is to enable transfer of the mother to a tertiary centre and to prolong pregnancy sufficiently so that glucocorticoids can be administered to the mother. There is little question that these short term objectives can be achieved with contemporary tocolytics. Whether tocolytics can maintain pregnancy for sufficient periods to enable in utero maturation to occur remains an unresolved question. When a decision is made to use tocolytics, the clinician is faced with a multitude of choices with side effects, efficacy and ease of administration generally being the most important considerations. Placebo‐controlled studies suggest that the β‐agonists, prostaglandin inhibitors and atosiban are effective in prolonging pregnancy for 24–48 hours. Of these three agents, atosiban has the best safety profile. There are no placebo‐controlled studies with calcium channel blockers or nitric oxide donors. However, because of their ease of use and efficacy compared with the β‐agonists, calcium channel blockers are widely used. Calcium channel blockers appear to have a better safety profile than the β‐agonists, but there are still significant cardiovascular side effects associated with their use. Indomethacin, although proven to be efficacious, has a safety profile that limits its utility for other than short courses. Magnesium sulphate is the most commonly used tocolytic in the United States, despite a lack of evidence for its efficacy. Although magnesium sulphate appears to have a good safety profile, serious side effects have been reported with its use. The choice of tocolytics is commonly based on personal preference. Whichever tocolytic is chosen, the fundamental parturitional process is not reversed by contemporary treatment, rather a reduction in uterine response to a stimulant; thus, the expectations of tocolytic treatment need to be reconsidered.

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Section: Pharmacokinetics and Pharmacodynamicsmentioning

confidence: 99%

Adverse effects of tocolytic therapy

Caritis

2005

BJOG

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“…f32-selective adrenoceptor agonists, such as salbutamol, terbutaline, ritodrine and fenoterol, are widely used in obstetric practice to stop premature contractions. The administration, in most clinics, is generally started by an intravenous infusion of the drug for some 24 h, followed by oral medication for several weeks (Ingemarsson, 1976;Lauersen et al, 1977;Richter, 1977;Ryden, 1977;Wallace et al, 1978). These selective 82-adrenoceptor agonists have also been administered orally as prophylactic treatment in pregnant women with a history indicating high risk of premature birth (Walters & Wood, 1977) as well as in twin pregnancies (Marivate, Villiers & Fairbrother, 1977;O'Connor, Murphy & Dalrymple, 1979).…”

Section: Introductionmentioning

confidence: 99%

Development of tolerance to oral salbutamol in the third trimester of pregnancy: a study of circulatory and metabolic effects.

Wager¹,

Bb²,

Lunell³

et al. 1981

Brit J Clinical Pharma

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1 The purpose of the study was to investigate whether a development of tolerance does occur or not to salbutamol-induced cardiovascular and metabolic effects after oral long term treatment in pregnancy. 2 Twenty-three women in late pregnancy were given an oral dose of 4 mg salbutamol in the morning after an overnight fast. Ten of the women had not been exposed to /3-adrenoceptor agonists earlier in their pregnancy (group A). Thirteen of the women had been treated with oral salbutamol in a dose of 4 mg four times a day for 12 to 33 days preceding the study (group B). 3 Blood samples were collected every 30 min for 120 min and analyzed for cyclic AMP, insulin, C-peptide, glucose, lactate, glycerol, non-esterified fatty acids (NEFA) and 3-hydroxybutyrate (3-HB). Heart rate and blood pressure were recorded simultaneously.4 In group A there was significant increase in plasma cyclic AMP and increased glycogenolysis, lipolysis and insulin secretion. In this group there were also significant cardiovascular effects, that is, an increase of heart rate and decrease of diastolic blood pressure. 5 In group B the effects of salbutamol were significantly less pronounced, indicating a development of tolerance. 6 We conclude that the metabolic side-effects are not sufficient reason to withhold -adrenoceptor agonists to healthy pregnant women with threatened premature labour, since tolerance rapidly develops to these actions.

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“…There is widespread application in the obstetrical field of the 0-adrenoceptor stimulating drugs, such as salbutamol, ritodrine and terbutaline. The most commonly used procedure to inhibit premature contractions with these drugs is to start with an intravenous infusion for about 24 hours, followed by oral medication for weeks, usually until the 36th week of gestation (5, 11,13,18).…”

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confidence: 99%

Metabolic and Circulatory Effects of Intravenous and Oral Salbutamol in Late Pregnancy in Diabetic and Non‐Diabetic Women

Wager¹,

Fredholm

Lunell³

et al. 1982

Acta Obstet Gynecol Scand

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Abstract. The present study investigated the cardiovascular and metabolic “side‐effects” of the β2‐adrenoceptor stimulating drug salbutamol in the third trimester of pregnancy in diabetic and non‐diabetic women. Salbutamol was administered either orally or as an intravenous infusion. Blood samples were collected for analyses of plasma cyclic AMP, insulin, C‐peptide, and carbohydrate and lipid metabolites. Fetal heart rate, maternal heart rate, and blood pressure were registered simultaneously. After both intravenous and oral salbutamol, there was a statistically significant decrease in diastolic blood pressure, increase in maternal heart rate, plasma levels of cyclic AMP, insulin, and carbohydrate and lipid metabolites showing stimulation of glycogenolysis, lipolysis, and insulin secretion. The increase in fetal heart rate was slight. In diabetic women, the glycogenolytic and lipolytic effects of salbutamol were significantly more pronounced than in non‐diabetics. The acute maternal circulatory and metabolic effects after salbutamol are probably too slight to have any clinical significance in healthy women. However, in diabetics, due to their impaired insulin function, a serious metabolic deterioration after salbutamol might occur.

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Inhibition of Premature Labor by Terbutaline

Cited by 55 publications

References 0 publications

Adverse effects of tocolytic therapy

Adverse effects of tocolytic therapy

Development of tolerance to oral salbutamol in the third trimester of pregnancy: a study of circulatory and metabolic effects.

Metabolic and Circulatory Effects of Intravenous and Oral Salbutamol in Late Pregnancy in Diabetic and Non‐Diabetic Women

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