RE: Terbutaline-its use as a tocolytic

["Loyd Helmick" <loyd_helmick@mediplane.com>]

We generally load the pts' with 4-6 grams then run a drip at 2-4 grams/hr.
Titrating for effect.  Of course monitoring FHT, contractions,  DTR's q 15".
We use Mag as the first line drug.  Caution when using Mag then Terb, there
is a  increased risk for developing pulmonary edema.  Generally Procardia is
something that the mothers' are sent home on.
Loyd Helmick
REACH
N. Cali

-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com]On Behalf Of Robert Cole
Sent: Tuesday, June 18, 2002 2:29 PM
To: 'flightmed@flightweb.com'
Subject: RE: Terbutaline-its use as a tocolytic



Just curious, what is the dosage and guidelines for MgSO4 in this setting...
Robert S. "Steve" Cole
Paramedic, CCEMTP
Education Department
Ada County Paramedics
208-375-7079
emcolers@adaweb.net

"...A mind stretched with new ideas never regains its former shape"


-----Original Message-----
From: Mauseth Patrice [mailto:Patrice.Mauseth@HCAHealthcare.com]
Sent: Tuesday, June 18, 2002 2:53 PM
To: 'flightmed@flightweb.com'
Subject: RE: Terbutaline-its use as a tocolytic


Indocin cannot be used after the gestational age of 32 weeks as it may close
the ductus arteriosus.  Ritodrine is the only tocolytic that is approved by
the FDA for the use of tocolysis.  No one in our area still uses Ritodrine.
The drugs of choice in our community are MgSO4 and Terbutaline.  We do also
use indocin and nifedipine, but not as a first line.  If you look at the
studies, none of them are proven to work, but it seems better than doing
nothing....  MgSO4 is shown to work in the short term.

Patti Mauseth, RN
Perinatal Transport/Outreach Coordinator
Good Samaritan Hospital
408 559-2153


> -----Original Message-----
> From:	Ken Lawson-Williams [SMTP:Macgyver@FlightMedicMail.com]
> Sent:	Friday, June 14, 2002 12:54 PM
> To:	flightmed@flightweb.com
> Subject:	Re: Terbutaline-its use as a tocolytic
>
> In Northern and Western Canada we use MgSO4 as a short term tocolytic for
> transport of a labouring mother (less than 4-6 cm dilation) to a tertiary
> center for delivery. In the Eastern Ardtic they use Ritodrine (Yutopar) as
> first line. Have also seen indocid used prior to medevac initiation. Have
> heard of PO ventolin (salbutamol) for long term prevention of labour and
> SQ for acute transport situations in Australia - I think it is the same
> drug as either terbutaline or albuterol. Perhaps an Australian or a
> pharmacist type on the list could confirm?
>
> Fly Safe.
> Ken L-W CCEMT-P/WMT
>
> "If in the last few years you haven't discarded a major opinion or
> acquired a new one, check your pulse. You may be dead."
> - Gelett Burgess
>
>
> --- ejvonmutzl@juno.com wrote:
> >I am researching the use of Terbutaline as a tocolytic in the air medical
> field. What are the pros and cons of using it? Is it part of your standing
> orders? Is there another medication that you prefer over Terbutaline for
> premature labor?
> >
> >Sincerely,
> >
> >Ed Mutzl  FP-C
> >Native Air
> >Mesa,AZ
> >
> >
> >
> >
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