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- Pharmacology For Terbutaline + Theophylline
Terbutaline + Theophylline Pharmacology
Terbutaline + Theophylline
About Terbutaline + TheophyllineN/AMechanism of Action of Terbutaline + TheophyllineN/APharmacokinets of Terbutaline + TheophyllineN/AOnset of Action for Terbutaline + TheophyllineN/ADuration of Action for Terbutaline + TheophyllineN/AHalf Life of Terbutaline + TheophyllineN/ASide Effects of Terbutaline + TheophyllineN/AContra-indications of Terbutaline + TheophyllineN/ASpecial Precautions while taking Terbutaline + TheophyllineN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Terbutaline + TheophyllineN/AInteractions for Terbutaline + TheophyllineN/ATypical Dosage for Terbutaline + TheophyllineN/ASchedule of Terbutaline + TheophyllineN/AStorage Requirements for Terbutaline + TheophyllineN/AEffects of Missed Dosage of Terbutaline + TheophyllineN/AEffects of Overdose of Terbutaline + TheophyllineN/ATerbutaline
About TerbutalineA ?2-adrenergic agonist,a fast-acting bronchodilator, Tocolytic,Anti asthma.Mechanism of Action of TerbutalineTerbutaline is a ?2 receptor agonist. Terbutaline directly relaxes the airway smooth muscles and produces bronchodilation. Stimulation of ?2 receptors activates Gs adenylyl-cyclase -cyclic AMP path way and produces reduction in smooth muscle tone. ?2 receptor agonists also increases the conductance of large Ca2+sensitive K+ channels in airway smooth muscles and leads to membrane hyperpolarisation and relaxation of smooth muscles.
Tocolytic action: In premature labour Terbutaline relaxes uterine smooth muscles and inhibits uterine contractions.
Pharmacokinets of TerbutalineAbsorption: It is partially absorbed (about 33- 50%) after oral administration
Distribution: It is widely distributed in the body.
Metabolism: It is partially metabolised in the liver to inactive compounds.
Excretion: Drug and its metabolites are excreted mainly in urine.
Onset of Action for Terbutaline30 minutes (oral), 15 minutes (subcutaneous), 5-30 minutes (inhalation)Duration of Action for Terbutaline4- 8 hours (oral), 1.5-4 hours (subcutaneous), 3- 6 hours (inhalation).Half Life of TerbutalineN/ASide Effects of Terbutaline1. Drowsiness
2. Headache
3. Dizziness
4. Nervousness
5. Tremor
6. Weakness
7. Palpitations
8. Tachycardia
9. Arrhythmia
10. Vomiting
11. Nausea
12. Heartburn
13. Diaphoresis
14. Dry and irritated nose (inhalation)
15. Hypokalaemia (high dose)
Contra-indications of Terbutaline1. Hypersensitivity to Terbutaline and other sympathomimetic amines.Special Precautions while taking Terbutaline1. Myocardial insufficiency
2. Arrhythmia
3. Hypertension
4. Hyperthyroidism
5. Epilepsy
6. Diabetes
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationUse with caution.Children Related InformationUse with caution
CHILDREN Below 12 years : contraindicated
NEONATES: contraindicated
Indications for Terbutaline1. Obstructive airway diseases
2. Acute Bronchospasm
3. Status asthmaticus
4. Premature labour
Interactions for TerbutalineOther Sympathomimetic bronchodilators or epinephrine: Combined effect on the cardiovascular system may be deleterious to the patient.
MAOIs and TCAs: Effect of terbutaline on vascular system may be potentiated.
Beta-adrenergic blocking agents: Block the pulmonary effect of terbutaline and may produce severe asthmatic attacks in asthmatic patients.
Beclomethasone, Theophylline: Synergy when used with these agents.
Food: Reduces bioavailability of terbutaline.Typical Dosage for TerbutalineAdult:
Oral: Initial dose: 7.5 mg / day in 3 divided doses, if needed dose can be increased to 15mg /day in 3 divided doses.
Subcutaneous /Intramuscular/slow IV infusion: 250 - 500mcg 3 - 4 times daily
Aerosol inhalation: 250 - 500mcg every 6 - 8 hours
Nebulised solution inhalation: 5 - 10 mg every 6 - 12 hours.
Children:
Oral: Initial dose: 2.5 mg in 2-3 times daily
Subcutaneous /Intramuscular/slow IV infusion: 10mcg /kg body weight dose can be increased to 300 mcg / day
Aerosol inhalation: 250 - 500mcg every 6 - 8 hours
Nebulised solution inhalation: 2 - 5 mg every 6 - 12 hours.
Premature labor (IV): Initial dose: 10mcg/minute and dose can be repeated until effective therapeutic response is obtained. Maximum dose: 80mcg/minute. Maintenance dose (IV dosage): Minimum effective dose for 4 hours.
Schedule of TerbutalineHStorage Requirements for TerbutalineStore at 15 - 30 degree C. Protect from heat and light.Effects of Missed Dosage of TerbutalineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of TerbutalineGive supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of drug can be reduced by administration of activated charcoal.Theophylline
About TheophyllineBronchodilator, a methylxanthine derivative, Anti asthma, in COPD.Mechanism of Action of TheophyllineIt inhibit phosphodiesterase enzyme which degrades cyclic nucleotides intracellularly and it results the cyclic AMP accumulation in the cell. This cause bronchodialatation, cardiac stimulation and vasodilatation. This drug release calcium from sarcoplasmic reticulam, especially in cardiac muscles and results increased cardiac muscle contraction. This drug also blocks adenosine receptors (adenosine acts as a local mediator in CNS & CVS and other organs- which contracts smooth muscles, especially in bronchi, blood vessels etc). This results bronchodialatation and vasodialatation.Pharmacokinets of TheophyllineAbsorption- Well absorbed after oral administration. Rapidly and well absorbed after intravenous administration.
Distribution- Widely distributed in the body. 40% bound to the plasma proteins.
Metabolism- Metabolized in the liver by demethylation and oxidation. 1-methyluric acid is its metabolite.
Excretion- Excreted through urine.
Onset of Action for Theophylline15 to 60 min. after oral administration and 15 minutes after intravenous administration.Duration of Action for TheophyllineN/AHalf Life of TheophyllineIts plasma half life is 8 hrsSide Effects of Theophylline1. Upset stomach
2. Stomach pain
3. Diarrhea
4. Headache
5. Restlessness
6. Insomnia
7. Irritability
8. Vomiting
9. Increased or rapid heart rate
10. Irregular heartbeat
11. Seizures
12. Skin rash
Contra-indications of Theophylline1. Hypersensitivity to the drug
2. Peptic ulcer
3. Underlying seizure disorders
Special Precautions while taking Theophylline1. Cardiac disease
2. Hypertension
3. Hyperthyroidism
4. Hepatic impairment
5. Fever
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for Theophylline1. Asthma
2. Chronic obstructive pulmonary disease
3. Chronic bronchitis
4. Emphysema
5. It can be used in premature infants who stop breathing
Interactions for TheophyllineBenzodiazepines: Sedative effects may be antagonized.
Beta agonists: Additive effect.
Halothane: Catecholamine induced arrhythmias may occur.
Tetracyclines: Theophylline adverse reaction may be enhanced.
Food: Theophylline elimination is increased by a low carbohydrate, high protein diet.
Typical Dosage for TheophyllineAdults:
Long term management of chronic bronchospasm: 300 to 1000 mg daily in divided doses in every 6 to 8 hrs or 175 to 500 mg every 12 hrs for modified release preparations.
Bronchospasm-
Adults-
5mg/kg body weight every 6 to 8 hrs.
Children- 5 mg/kg every 4 to 6 hrs.
Neonatal apnoea of prematurity-
Child-
More than 24days - 5mg/kg as maintenance dose and 1.5mg/kg every 12 hrs as loading dose.
Less than 24 days- 1mg/kg every 12 hrs.
Intravenous- Management of severe bronchospasm-
Adult- 4 to 5 mg/kg as loading dose over 20 to 30 minutes.
0.4 mg/kg/hr as maintenance dose.
Children- 4 to 5 mg/kg as loading dose over 20 to 30 minutes.
0.8mg/kg/hr as maintenance dose.
Schedule of TheophyllineN/AStorage Requirements for TheophyllineStore it at room temperature and away from excess heat and moisture.Effects of Missed Dosage of TheophyllineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of TheophyllineGive symptomatic and supportive treatment. Induce emesis except in convulsive patient. Administer activated charcoal or cathartics to prevent further absorption of the drug.Home Delivery for Terbutaline + Theophylline in Your City
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However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for terbutaline + theophylline and other medicines and health products. Home delivery services for terbutaline + theophylline may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.
Please be aware that you should take terbutaline + theophylline only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for terbutaline + theophylline before they complete the sale. You can get this information while placing the order for terbutaline + theophylline with the pharmacy.
Terbutaline + Theophylline is a generic medicine name and there are several brands available for it. Some of the brands for terbutaline + theophylline might be better known than terbutaline + theophylline itself. If the pharmacy that's willing to deliver medicines to your home doesn't have terbutaline + theophylline in stock, you can ask for one of the branded alternatives for terbutaline + theophylline.