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μμ© κΈ°μ : Terbutaline selectively binds to and stimulates **beta-2 adrenergic receptors** located predominantly in bronchial, vascular, and uterine smooth muscle. **Mechanism Pathway:** Beta-2 receptor activation β Stimulation of **adenylyl cyclase** β Increased intracellular **cyclic AMP (cAMP)** β Activation of **protein kinase A (PKA)** β Decreased intracellular calcium concentrations β **Smooth muscle relaxation**. This results in significant bronchodilation and reduced airway resistance. At therapeutic doses, it has minimal affinity for **beta-1 receptors** (cardiac muscle) and virtually no **alpha-adrenergic** activity.
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- For acute exacerbations of feline asthma treated at home Β· 0.01 mg/kg SC or IM Β· SC/IM Β· PRN Β· Beneficial response occurs in 15-30 minutes. A heart rate approaching 240 BPM indicates absorption.
- For feline asthma Β· 0.312-0.625 mg (total dose) per cat PO two to three times daily Β· PO Β· q8-12h Β· May adjust dose up to 1.25 mg in larger cats if needed
- For bradyarrhythmias Β· 0.625 mg PO q8-12h Β· PO Β· q8-12h Β· Improvement usually partial and often temporary
- For acute bronchoconstriction (initial crisis) Β· 0.01 mg/kg IV, SC, IM Β· IV/SC/IM Β· Single dose
- For use as a quantitative intradermal terbutaline sweat test (QITST) to identify anhidrosis Β· Eight 0.1 mL intradermal injections of serial 10-fold dilutions of terbutaline sulfate in 0.9% saline (0.001, 0.01, 0.1, 1, 10, 100 and 1000 mg/L) Β· Intradermal Β· Single dose Β· ARCI UCGFS Class 3 Drug
- General bronchodilation Β· 0.0033 mg/kg IV Β· IV Β· Not specified Β· ARCI UCGFS Class 3 Drug
- For a trial to treat intrathoracic tracheal collapse, expiratory cough or dyspnea and marked exercise intolerance Β· 1.25-5 mg (total dose) PO two to three times daily Β· PO Β· q8-12h
- As a bronchodilator in chronic bronchitis Β· Small dogs: 0.625-1.25 mg (total dose) PO q12h; medium-sized dogs: 1.25-2.5 mg (total dose) PO q12h; large dogs: 2.5-5 mg PO q12h Β· PO Β· q12h
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- Known hypersensitivity to terbutaline
- Heart disease (especially congestive heart failure or cardiomyopathy)
- Known hypersensitivity to terbutaline or sympathomimetic amines
- Severe cardiac arrhythmias
- Hypertrophic cardiomyopathy (relative contraindication)
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- Increased heart rate (tachycardia)
- Tremors
- CNS excitement (nervousness)
- Dizziness
- Sweating (reported in horses after parenteral injection)
- Transient hypokalemia
- Tachycardia
- Muscle tremors
- Restlessness or excitement
- Hypokalemia (with high doses or prolonged use)
- Hypertension or hypotension
μ½λ¬Ό μνΈμμ©
- Inhalation Anesthetics (e.g., halothane, isoflurane, methoxyflurane) Β· May predispose the patient to ventricular arrhythmias, particularly with preexisting cardiac disease; use cautiously.
- Beta-Adrenergic Blocking Agents (e.g., propranolol) Β· May antagonize the bronchodilating and cardiovascular actions of terbutaline.
- Digoxin Β· Concurrent use with digitalis glycosides may increase the risk of cardiac arrhythmias. Β· moderate
- Monoamine Oxidase Inhibitors (MAOIs) Β· May potentiate the vascular effects of terbutaline.
- Other Sympathomimetics Β· May increase the risk of developing adverse cardiovascular effects.
- Tricyclic Antidepressants Β· May potentiate the vascular effects of terbutaline.
- Beta-blockers (e.g., propranolol) Β· Antagonize the bronchodilating effects of terbutaline Β· major
- Sympathomimetics Β· Additive cardiovascular toxicity and CNS stimulation Β· moderate
- Inhalant anesthetics (e.g., halothane) Β· Sensitize the myocardium, increasing the risk of severe arrhythmias Β· major
- Tricyclic antidepressants (TCAs) / MAOIs Β· May potentiate vascular effects Β· moderate
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- Clinical symptom improvement (respiratory rate/effort)
- Auscultation of lung sounds
- Cardiac rate and rhythm (especially if indicated for arrhythmias or if tachycardia develops)
- Serum potassium (early in therapy if the animal is susceptible to hypokalemia)
- Heart rate and rhythm
- Respiratory rate and effort
- Serum potassium levels (with prolonged or high-dose therapy)
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Clinical signs of significant systemic overdose may include **arrhythmias** (bradycardia, tachycardia, heart block, extrasystoles), **hypertension, fever, vomiting, mydriasis, and CNS stimulation**. **Treatment:** - For recent oral ingestion without significant cardiac/CNS effects: Empty gut, administer activated charcoal, and a cathartic. - For severe cardiac arrhythmias: A beta-blocking agent (e.g., propranolol) can be used, but **caution is advised** as it may precipitate severe bronchoconstriction.
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