Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial

Motazedian, Shahdokht; Ghaffarpasand, Fariborz; Mojtahedi, Khatereh; Asadi, Nasrin

doi:10.4103/0256-4947.67079

Cited by 18 publications

(12 citation statements)

References 15 publications

(22 reference statements)

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“…Similar to the authors’ present results, Motazedian et al reported that a 48-hour prolongation of pregnancy was achieved in 87% patients receiving terbutaline and 84% patients receiving salbutamol 10. Likewise, the study at Siriraj Hospital, Bangkok, Thailand, revealed that the success rate in threatened preterm labor inhibition for 12 hours with nifedipine was about 80% 11.…”

Section: Discussionsupporting

confidence: 89%

Success rate in preterm uterine contraction inhibition with tocolytic agents in a tertiary care center

Kiatsuda

Thinkhamrop

Prasertcharoensuk

2016

IJWH

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ObjectiveThis study aims to assess the success rate of inhibiting preterm uterine contraction with tocolytic agents to delay delivery for at least 48 hours and risk factors of failure inhibition.Materials and methodsBetween January 2013 and July 2014, medical records of all singleton pregnant women between 24 0/7 and 33 6/7 weeks of gestation with the diagnosis of preterm labor (with cervical dilatation) or threatened preterm labor (without cervical dilatation) who received tocolytic agents were reviewed. The success rate of preterm uterine contraction inhibition was accounted in patients with 48 hours delayed delivery. The risk factors of the inhibition failure and neonatal outcomes were also investigated in this study.ResultsAmong 424 pregnant women diagnosed of preterm labor or threatened preterm labor, 103 singleton pregnant women met the study criteria. Overall success rate of preterm uterine contraction inhibition to prolong pregnancy for at least 48 hours was 86.4% (95% confidence interval [CI]: 78.3, 92.3). However, the success rate among the threatened preterm labor group was 93.8% (95% CI: 88.3, 99.1) while the preterm labor group was 60.9% (95% CI: 39.3, 82.4). The significant factor associated with inhibition failure was preterm labor (adjusted odds ratio 7.22; 95% CI: 1.99, 26.20).ConclusionThe success rate of preterm uterine contraction inhibition with tocolytic agents to delay delivery for at least 48 hours was high in threatened preterm labor and low in preterm labor. A significant risk factor for inhibition failure was the preterm uterine contraction with cervical change.

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Section: Discussionsupporting

confidence: 89%

Success rate in preterm uterine contraction inhibition with tocolytic agents in a tertiary care center

Kiatsuda

Thinkhamrop

Prasertcharoensuk

2016

IJWH

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“…Details of the characteristics of the trials and comparison of the quality of tocolytic studies retrieved are reported elsewhere 16. Twenty five trials contained a placebo arm (26%),27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 60 included beta mimetics (63%),27 28 29 31 34 35 36 37 39 43 46 48 50 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 29 included magnesium sulfate (31%),29 30 33 38 47…”

Section: Resultsmentioning

confidence: 99%

Tocolytic therapy for preterm delivery: systematic review and network meta-analysis

Haas

Caldwell

Kirkpatrick

et al. 2012

BMJ

348

242

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Objective To determine the most effective tocolytic agent at delaying delivery.Design Systematic review and network meta-analysis. Study selection Randomised controlled trials of tocolytic therapy in women at risk of preterm delivery. Data sources Data extractionAt least two reviewers extracted data on study design, characteristics, number of participants, and outcomes reported (neonatal and maternal). A network meta-analysis was done using a random effects model with drug class effect. Two sensitivity analyses were carried out for the primary outcome; restricted to studies at low risk of bias and restricted to studies excluding women at high risk of preterm delivery (those with multiple gestation and ruptured membranes). ResultsOf the 3263 titles initially identified, 95 randomized controlled trials of tocolytic therapy were reviewed. Compared with placebo, the probability of delivery being delayed by 48 hours was highest with prostaglandin inhibitors (odds ratio 5.39, 95% credible interval 2.14 to 12.34) followed by magnesium sulfate (2.76, 1.58 to 4.94), calcium channel blockers (2.71, 1.17 to 5.91), beta mimetics (2.41, 1.27 to 4.55), and the oxytocin receptor blocker atosiban (2.02, 1.10 to 3.80). No class of tocolytic was significantly superior to placebo in reducing neonatal respiratory distress syndrome. Compared with placebo, side effects requiring a change of medication were significantly higher for beta mimetics (22.68, 7.51 to 73.67), magnesium sulfate (8.15, 2.47 to 27.70), and calcium channel blockers (3.80, 1.02 to 16.92). Prostaglandin inhibitors and calcium channel blockers were the tocolytics with the best probability of being ranked in the top three medication classes for the outcomes of 48 hour delay in delivery, respiratory distress syndrome, neonatal mortality, and maternal side effects (all cause).Conclusions Prostaglandin inhibitors and calcium channel blockers had the highest probability of delaying delivery and improving neonatal and maternal outcomes.

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“…Moreover, R-sal at a lower dose could have a potential in reducing its cardiotoxicity side effects. Additionally, an oral dose of 25mg/d salbutamol in pregnant woman for prevention of preterm labor has been reported by Motazedian[39]. Most importantly, selective stimulation of β2-adrenoreceptor is reported to antiapoptotic rather than cardiotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Rescuable effect of R-salbutamol in LPS-induced immune dysfunction of sepsis

Beng

Wang

et al. 2021

Preprint

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Sepsis is a severe life-threatening condition caused by a dysregulated host response to infection. So far, there are no pharmacotherapies to stop sepsis. Salbutamol, an commonly used β2-adrenoreceptor agonist, has found to be potential in regulating immune response dysfunction and exert anti-inflammatory effect. However, salbutamol exists two isomers. R-isomer exhibits the therapeutic effect and clinical benefit, while S-isomer proves to be detrimental rather than benign. So, in this study, we investigated the preventive and therapeutic effect of R-salbutamol (R-sal), S-salbutamol (S-sal) or racemic mixture in a mouse model of lipopolysaccharide (LPS)-induced sepsis. Dexamethasone (Dex) was set as comparison. The results showed that R-sal markedly improved seven-day survival rate of septic mice both administered before or after LPS. Whereas Dex showed toxic and accelerated the death of septic mice when given before LPS injection. Lung histological examination and lung function assay revealed that LPS challenge resulted in acute lung damage, including inflammatory cell infiltration, thickened alveolar septa and congestion, and decreased minute volume in septic mice. R-sal pretreatment efficiently inhibited these changes, accompanying by markedly reduced lung MPO level, serum cytokines levels and lactate release and significantly restored the lymphocytes and suppressed the percentage of monocytes. Racemic mixture exhibited diminished effects while S-sal showed enhanced cytokines release. In addition, R-sal pretreatment showed a better improvement in prognostic pulmonary function at day4 in survived mice than that of Rac-sal. Collectively, our results indicate the potential benefit of R-sal for sepsis and sepsis-induced lung injury.

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Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial

Cited by 18 publications

References 15 publications

Success rate in preterm uterine contraction inhibition with tocolytic agents in a tertiary care center

Success rate in preterm uterine contraction inhibition with tocolytic agents in a tertiary care center

Tocolytic therapy for preterm delivery: systematic review and network meta-analysis

Rescuable effect of R-salbutamol in LPS-induced immune dysfunction of sepsis

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