Effects of tenofovir disoproxil fumarate/tenofovir alafenamide: A Synthesis of Findings from 17 Studies

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Original Abstract of the Article

Main Research Findings

The studies reviewed focused on the effects of terbutaline, a medication commonly used to treat asthma, and its interactions with other drugs. 4 found that enalapril and spironolactone, potassium-sparing drugs, can help prevent potassium depletion caused by terbutaline. 11 demonstrated that combining terbutaline with theophylline, another asthma medication, resulted in enhanced bronchodilation and reduced tremor. 1 revealed that terbutaline, when administered subcutaneously, effectively alleviated asthma symptoms in children. 14 investigated the impact of low doses of terbutaline and theophylline, finding terbutaline alone produced significant bronchodilation, while theophylline did not offer additional benefit. 8 compared different terbutaline inhalation methods, concluding that the method of administration does not significantly impact its bronchodilator effects. 5 compared the effects of terbutaline, salbutamol, and adrenaline in children with asthma, finding terbutaline to be the most effective bronchodilator. 2 examined the effects of inhaled terbutaline in patients with airway obstruction, indicating a good bronchodilator effect with minimal adverse effects on heart rate and tremor. 15 investigated the potential impact of regular terbutaline treatment on the effectiveness of inhaled budesonide, a corticosteroid. 6 investigated the effects of bambuterol, a terbutaline prodrug, finding that it provided longer-lasting bronchodilation with fewer side effects. 9 explored the use of vaginally administered terbutaline for premature labor, showing it can be quickly absorbed and effectively reduce contractions. 3 observed that women are more susceptible to the potassium-depleting and electrocardiographic effects of inhaled terbutaline. 16 investigated the hemodynamic, cardiac, and electrolyte effects of inhaled terbutaline, focusing on potential tolerance development. 17 examined the development of tolerance and rebound bronchoconstriction after regular inhaled terbutaline treatment. 10 examined the potential of theophylline to enhance the effects of inhaled terbutaline. 12 compared the cardiovascular effects of intramuscular and inhaled terbutaline, indicating that nebulized terbutaline has minimal circulatory effects. 13 compared the bronchodilator effects of pressurized terbutaline delivered with a spacer and nebulized terbutaline, finding no significant difference. 7 investigated the dose-response relationship of bambuterol, a terbutaline prodrug, revealing a correlation between plasma terbutaline levels and bronchodilator effects.

Benefits and Risks

Benefits Summary

Terbutaline has been shown to be an effective bronchodilator, providing relief from asthma symptoms. It is generally well-tolerated, particularly when administered by inhalation. 1 5 2 11 13

Risks Summary

Terbutaline can cause side effects, including tremor, heart palpitations, and hypokalemia (low potassium levels). 4 3 16 17 12 7 It is important to use terbutaline as directed by a healthcare professional and to be aware of potential risks and side effects. 6

Study Comparisons

Study Commonalities

The studies highlighted the effectiveness of terbutaline in managing asthma symptoms. They generally found that terbutaline provided bronchodilation and improved lung function. 14 8

Study Differences

The studies employed different methodologies, including variations in patient populations, dosage, and routes of administration. 1 5 2 15 6 9 3 16 17 10 12 13 7 This resulted in variations in observed effects and potential side effects, such as the higher sensitivity to terbutaline's potassium-lowering effects observed in women. 3

Consistency and Contradictions in the Results

While terbutaline has proven effective as a bronchodilator for asthma, some studies indicate potential risks, such as hypokalemia and the development of tolerance. 4 16 17 7 Further research is needed to fully assess the long-term effects and safety of terbutaline use. 15

Practical Considerations

Terbutaline is generally considered a safe and effective medication for asthma management when used as directed by a healthcare professional. However, individuals should be aware of potential risks and side effects, and discuss any concerns with their doctor. 11 10

Limitations of Current Research

The research reviewed primarily focuses on short-term effects and safety, and further investigation is needed to understand long-term implications. 11

Future Research Directions

Long-term studies are needed to assess the full range of effects, both beneficial and potentially adverse, of terbutaline use. 16 17

Conclusion

Terbutaline is a valuable tool for asthma management, providing bronchodilation and symptom relief. 1 5 2 14 8 7 13 12 10 11 17 However, it's essential to use it under the guidance of a doctor and be aware of potential risks. 4 3 16 15 6 9 Further research is necessary to explore the long-term effects and refine its safe and effective use in treating asthma. 7

Literature analysis of 17 papers
Positive Content
15
Neutral Content
0
Negative Content
2
Article Type
17
0
0
0
17
1.

Comparison of subcutaneous terbutaline with epinephrine in the treatment of asthma in children.

Author: SlyR M, BadieiB, FacianeJ

Bronchodilation for asthma
Fast-acting
Long-lasting
Increased pulse rate

Terbutaline and epinephrine were both effective in treating acute asthmatic attacks in children. Bronchodilation was maintained for 4 hours after administration of either drug. Terbutaline caused small increases in pulse rate, while epinephrine did not.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Bronchodilatory and circulatory effects of two doses of a beta2-agonist (terbutaline) inhaled with IPPB in patients with reversible airways obstruction.

Author: SimonssonB G, SvedenbladH, StrömB

Bronchodilator effect
Increased PEFR
Palpitations
Tremor

Inhaled terbutaline (2.5 and 5 mg) effectively improved peak expiratory flow rate (PEFR) and forced expiratory volume in one second (FEV1) in patients with asthma. Higher doses resulted in greater and longer-lasting effects. While some patients experienced tremor and palpitations, terbutaline generally had minimal systemic effects on heart rate and tremor.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Sex differences in hypokalaemic and electrocardiographic effects of inhaled terbutaline.

Author: RahmanA R, McDevittD G, StruthersA D, LipworthB J

Hypokalaemic effects

Women are more sensitive to the hypokalaemic, chronotropic, and electrocardiographic sequelae of inhaled terbutaline.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

The effects of enalapril and spironolactone on terbutaline-induced hypokalemia.

Author: RahmanA R, McDevittD G, StruthersA D, LipworthB J

Potassium level increase
Not for preventing hypokalemia

Enalapril and spironolactone protect against the fall in serum potassium by elevating baseline potassium concentration. However, they should not be used to prevent the hypokalemic and electrocardiographic sequelae of inhaled beta 2-agonists.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Comparison of subcutaneous injections of terbutaline, salbutamol and adrenaline in acute asthmatic attacks in children.

Author: PhanichyakarnP

Bronchodilation
Diastolic blood pressure decrease
Increased heart rate
Systolic blood pressure increase

Terbutaline, adrenaline, and salbutamol, bronchodilator drugs, were compared for their effects on bronchodilation and cardiovascular function in a randomized study. Terbutaline showed the most potent bronchodilation, while all drugs caused increases in heart rate, systolic blood pressure, and respiratory rate.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Bambuterol: clinical effects of three doses of bambuterol once daily in asthmatic patients.

Author: ClemmensenI H, PedersenB K, RavnS, LaursenL C, WeekeB

Effective for asthma
Well tolerated
No significant risks mentioned

Bambuterol, a terbutaline pro-drug, was effective in treating asthma in 22 patients. The dose of 0.270 mg/kg was preferable, with no significant side effects observed.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

Bambuterol: dose response study of a new terbutaline prodrug in asthma.

Author: Holstein-RathlouN H, LaursenL C, MadsenF, SvendsenU G, GnosspeliusY, WeekeB

Bronchodilator activity
Prolonged bronchodilation
Cardiac side effects
Tremor

Bambuterol, a prodrug of terbutaline, produced more prolonged bronchodilation than terbutaline. However, bambuterol was associated with more tremor and cardiac side effects at higher doses.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

8.

Effects of divided doses of a bronchodilator aerosol and the intervening time interval on the forced expiration.

Author: HidingerK G, BakeB

Bronchodilation

There was no significant difference in bronchodilation achieved with 500 micrograms of terbutaline in one inhalation, 125 micrograms in four inhalations taken in rapid succession, or 125 micrograms in four inhalations with a 30-minute interval between doses.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

On resorption and the effects of vaginally administered terbutaline in women with premature labor.

Author: KullanderS, SvanbergL

Premature labor inhibition
Low blood levels

Vaginally administered terbutaline sulfate significantly inhibited contractions in premature labor within 30 minutes for a 0.1 mg dose in cellulose gel and within 2 hours for a 10% terbutaline sulphate ring. No side effects were noted.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Does theophylline potentiate inhaled beta 2-agonists?

Author: SvedmyrK, SvedmyrN

Better distribution of inhaled terbutaline
Potentiation of inhaled beta 2-stimulants

Theophylline and terbutaline, when administered intravenously or orally, did not potentiate the effect of inhaled terbutaline in asthmatics. The potentiation seen with intravenous and oral pretreatment was likely due to the different routes of administration, which may have improved the distribution of inhaled terbutaline.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Effects of oral theophylline combined with oral and inhaled beta-2-adrenostimulants in asthmatics.

Author: SvedmyrK

Improved bronchodilation
Maximal bronchodilation
Minimum side effects
Reduced tremor

A combination of low-dose oral terbutaline and theophylline was more effective in treating asthma than a high dose of terbutaline alone, with significantly less tremor. The combination provided an additional bronchodilating effect when inhaled terbutaline was added.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Cardiovascular effects of intramuscular or inhaled terbutaline in asthmatics.

Author: BuchJ, BundgaardA

Bronchodilation
Minimal circulatory effects

Nebulized terbutaline provided maximal bronchodilation with minimal circulatory effects in asthmatic patients, compared to intramuscular administration which had more pronounced circulatory effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Cumulative dose-response study comparing terbutaline pressurized aerosol administered via a pearshaped spacer and terbutaline in a nebulized solution.

Author: MadsenE B, BundgaardA, HidingerK G

Bronchodilator effect

Terbutaline administered via a pressurized aerosol with a spacer is as effective as nebulized terbutaline in treating bronchospasm.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

Bronchodilator effects of low doses of oral theophylline and terbutaline in asthmatic subjects.

Author: DeutschR I, TashkinD P, SimmonsM, CalvareseB, WangerJ, LeeY E

Effective bronchodilation

Terbutaline produced significant bronchodilatation in asthmatic subjects, while theophylline did not produce greater bronchodilatation than placebo. Theophylline did not provide additional bronchodilatation when combined with terbutaline.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Effect of regular terbutaline on the airway response to inhaled budesonide.

Author: WildingP J, ClarkM M, OborneJ, BennettJ A, TattersfieldA E

Improved lung function
Reduced symptoms

The study examines the effects of budesonide alone and in combination with regular terbutaline treatment on lung function, symptoms, and bronchial reactivity in asthmatic patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Hemodynamic, cardiac, and electrolyte effects of low-dose aerosolized terbutaline sulfate in asthmatic patients.

Author: BradenG L, GermainM J, MulhernJ G, HaferJ G, BriaW F

Beta-adrenergic tolerance
Decreased potassium
Increased heart rate
Increased morbidity

This study aimed to investigate whether beta-adrenergic tolerance to inhaled terbutaline develops during 14 days of maintenance therapy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

17.

Bronchodilator tolerance and rebound bronchoconstriction during regular inhaled beta-agonist treatment.

Author: HancoxR J, CowanJ O, FlanneryE M, HerbisonG P, McLachlanC R, TaylorD R

Asthma control
Airway tolerance
Rebound bronchoconstriction

Regular terbutaline treatment in asthma was found to lead to a temporary increase in morning peak flows and a greater than expected rise in evening peak flows for the first 2 days of treatment, suggesting the development of tolerance to the bronchodilator effect of terbutaline.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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