RE: Terbutaline-its use as a tocolytic

[Mauseth Patrice <Patrice.Mauseth@HCAHealthcare.com>]

4-6 gm IV bolus over 20 minutes, with a 2-3 gm/hr maintenance dose via
infusion pump.  You can monitor MgSO4 levels by measuring DTR's and
respiration rates.  Pregnant women should not have an R rate below 12.  Of
course, you can also draw serum levels, but that is not feasible in the air.
The main thing to remember is Mg is excreted via the kidneys, so you need to
watch her output carefully.

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


> -----Original Message-----
> From:	Robert Cole [SMTP:EMCOLERS@adaweb.net]
> 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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