What are the effects on a Mother and Baby when treated for preterm labor with Terbutaline?
36 weeks preterm
- EndoLv 61 decade agoFavorite Answer
Terbutaline is in FDA pregnancy category B, meaning that it is not expected to be harmful to an unborn baby.
The most common side effects are:
increased heart rate
Most of the other side effects are less common. If you experience any of these symptoms, you should contact your doctor promptly. If your doctor does not respond to your reports of adverse side effects, consider seeking a second opinion. Also, because of the risks of terbutaline, you should be screened carefully for any pre-existing health conditions.
Mild adverse effects
Headache, dizziness, drowsiness, restlessness, insomnia (infrequent)
Rapid, pounding heartbeat; increased sweating; muscle cramps in arms and legs (infrequent to frequent)
Nausea, heartburn, vomiting (rare with oral form, frequent with IV)
Increased blood sugar (frequent- 40% abnormal one-hour glucose test)
Serious adverse effects
Rapid or irregular heart rhythm, intensification of angina, increased blood pressure (infrequent)
Lowered blood calcium or potassium (especially with intravenous use) (possible)
Liver toxicity (case reports)
Severe lowering of blood pressure (hypotension) (case reports)
Increased blood sugar (infrequent)
Seizures (rare reports)
Effects of overdosage
Nervousness, palpitation, rapid heart rate, sweating, headache, tremor, vomiting, chest pain
Terbutaline's side effects are more severe at higher dosages. As a reference point, the maximum dose of oral terbutaline for asthmatics is 15 mg per 24-hour period (The Essential Guide to Prescription Drugs, 1998 and 1999 Physicians' Desk Reference). However, women experiencing preterm labor will take terbutaline around-the-clock and often in significantly higher doses. At a dose of 5 mg every six hours, a woman is taking a total of 20 mg per 24 hour period, or 33% more than this maximum dose for asthmatics. At 5 mg every 4 hours, she is taking 30 mg per 24-hour period, or double the maximum dose for asthmatics. Sometimes the dosages of terbutaline for preterm labor can be even higher than 30 mg.
Some of terbutaline's more serious side effects include cardiovascular complications. These symptoms include:
Dizziness or blackout
Tachycardia (rapid heart rate)*
Irregular heart rate
Frequent skipping of a heartbeat
Shortness of breath
Severe anxiety or restlessness
studies show some conditions put women at greater risk for serious complications. These conditions include: a pre-existing heart condition, diabetes, pre-eclampsia and twin or higher order pregnancy. Women with pre-existing heart conditions should check with their cardiologist before taking terbutaline. In addition, fluid overload and combining terbutaline with other preterm labor drugs and/or corticosteroids (drugs, such as betamethasone, that mature the baby's or babies' lungs) also can increase a woman's risk of complications.
The dosage of terbutaline also affects the incidence and severity of side effects. Specifically, the risk of severe side effects is higher at higher doses.
4. Does terbutaline have any effect on my baby(ies)?
Terbutaline's effect on babies has not been widely studied. However, terbutaline is generally believed to have fewer side effects on the neonate than on the mother. A link with a list of neonatal side effects can be found at http://www.geocities.com/HotSprings/Villa/3604/neo...
Alternatives to Terbutaline:
Magnesium sulfate also is used as a preterm labor drug. It is typically given by IV in the hospital. It must be administered in high levels; the line between a "therapeutic" dose and one that is "toxic" is quite thin. Therefore, women on it must be monitored carefully for complications. Magnesium sulfate also has been thought to be safe for babies, although a recent study has raised some doubts.
A heart drug called Procardia (aka nifedipine) is viewed as causing fewer maternal side effects than terbutaline. However, it has not been widely studied.
Ritodrine, the only FDA-approved drug to treat preterm labor, has similar side effects to terbutaline. It had fallen out of favor in comparison to terbutaline because it is more expensive. Ritodrine recently was voluntarily taken off the market by its manufacturer.
Research about Indomethacin is limited, although some studies have linked its use to adverse effects on the baby or babies.
Bedrest and hydration
In addition to prescription drugs, bedrest and drinking plenty of water are often prescribed to treat preterm labor. Bedrest is frequently prescribed although research is lacking on whether it actually works. Sometimes dehydration will cause a woman to have contractions. Drinking lots of fluids can help lessen this problem.
Questions To Discuss With Your Doctor
Am I really experiencing preterm labor (dilated and effaced cervix)?
What dosage of terbutaline will I be taking?
What form of terbutaline will I take?
Do you prescribe the terbutaline pump and under what conditions?
How long will I take terbutaline?
At what gestational age do you think the risks outweigh the benefits of taking terbutaline?
How will you monitor my health while I'm on terbutaline and how often?
What happens if I experience adverse side effects?
What's your position on combining preterm labor drugs?
What's your position on the use of corticosteroids (drugs to mature the baby or babies' lungs)?
Are there any non-drug alternatives to terbutaline?Source(s): Twins List FAQs: http://www.twinslist.org Copyright © 1996 - 2006 Mary Foley
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