Re: Terbutaline-its use as a tocolytic

["Andrew Berry" <ABerry@nets.org.au>]

In our country the principal tocolytics are IV salbutamol (Ventolin)
which as a beta-sympathomimetic is similar to but not the same as
terbutaline, ritodrine (Yutopar) and oral nifedipine (Adalat). Glyceryl
trinitrate patches are sometimes used but the evidence is sparse for
their routine use.
Ventolin is not approved for this use in the USA but is in most
countries. [It's use in asthma is similarly restricted in the USA].
Much promise comes from nifedipine, a calcium antagonist which is
equally effective as salbutamol, is administered orally and has fewer
maternal side effects. However, it's use in pregnancy is not yet
approved in Australia. Considering all of that, clinical practice is to
use either IV salbutamol or oral nifedipine. For those who are
interested, full details of our approach is outlined on our website
(http://www.nets.org.au/main/Circulars.html), along with supporting
references. Other useful references are Drugs for Women in Preterm
Labour (www.rcog.org.uk/guidelines/tocolytic.html) and Care Around
Preterm Birth
(www.health.gov.au/hfs/nhmrc/publicat/synopses/cp51syn.htm)

Dr Andrew Berry ABerry@nets.org.au
State Director
NETS (NSW Emergency Transport Service)
nets.org.au

Hotline    +61 1300 36 2500
Office     +61 1300 36 2499
Facsimile  +61 1300 36 2498

Personal   +61 (0)2 9633 8770

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>>> ejvonmutzl@juno.com 15/06/2002 5:06:56 >>>
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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