RE: Terbutaline-its use as a tocolytic

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

MgSO4 and Terb causing pulmonary edema is more of an issue in older maternal
patients.  (>35)  It is used quite frequently together.  

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


> -----Original Message-----
> From:	Loyd Helmick [SMTP:loyd_helmick@mediplane.com]
> Sent:	Tuesday, June 18, 2002 3:55 PM
> To:	flightmed@flightweb.com
> Subject:	RE: Terbutaline-its use as a tocolytic
> 
> 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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