Terbutaline Halothane

INHALATIONAL- HALOTHANE TERBUTALINE, THEOPHYLLINE Cases of arrhythmias when these bronchodilators are co-administered with halothane Possibly due to sensitization of the myocardium to circulating catecholamines by the volatile anaesthetics to varying degrees Risk of cardiac events is higher with halothane. Desflurane is irritant to the upper respiratory tract, and t secretions can occur and are best avoided in patients with bronchial asthma. Sevoflurane is non-irritant and unlikely to cause serious adverse effects... 

Clinically important, potentially hazardous interactions with albuterol, alpha-blockers, amitriptyline, amoxapine, atenolol, beta-blockers, carteolol, chlorpromazine, clomipramine, cocaine, desipramine, doxepin, ephedra, ergotamine, furazolidone, halothane, imipramine, insulin detemir, MAO inhibitors, metoprolol, nadolol, nortriptyline, oxprenolol, penbutolol, phenelzine, phenoxybenzamine, phenylephrine, pindolol, prazosin, propranolol, protriptyline, sympathomimetics, terbutaline, thioridazine, timolol, tranylcypromine, tricyclic antidepressants, trimipramine, vasopressors... 

Two patients developed arrhythmias when terbutaline was given to patients anaesthetised with halothane. 

Two patients developed ventricular arrhythmias while anaesthetised with halothane and nitrous oxide/oxygen when given terbutaline 250 to 350 micrograms subcutaneously for wheezing. Both developed unifocal premature ventricular contractions followed by bigeminy, which responded to lidocaine. Halothane was replaced by enllurane in one case, which allowed the surgery to be completed without further incident. ... 

Halothane is known to cause arrhythmias and it has been suggested that it may increase susceptibility to the adverse cardiac effect of beta-agonist bronchodilators, which can cause arrhythmias. Note that beta agonists such as terbutaline are sympathomimetics (see Table 24.1 , (p.879)), like adrenaline (epinephrine), which has also been shown to cause arrhythmias in the presence of halothane (see Anaesthetics, general + Inotropes and Vasopressors , p.99). 

Thiagarajah S, GrynsztejnM, LearE, Azarl. Ventricular arrh3 tiraiias after terbutaline administration to patients anesthetized with halothane. Anesth Ancdg (1986) 65,417-8. 

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