Terbutaline COVID Patients


Terbutaline (Brethine, Brethaire) is a Beta2 Agonist to be considered in place of Albuterol and Combivent to avoid nebulizer use during the COVID pandemic.


Classification/ Action:


  • Terbutaline is a Beta2 Agonist. It stimulates the Beta2 receptor, producing relaxation of bronchial smooth muscle and bronchodilation.


Clinical Indications:


  • Acute bronchospasm




  • Known sensitivity to sympathomimetic


  • Use with caution in patients with hypertension, cardiac disease, cardiac arrhythmias, diabetes, Thyrotoxicosis and/or seizure disorders.


Dosage and route:


Note this medication must be given Subcutaneously (SQ). It cannot be given IV or IM


  • Adults
    • 0.25mg SQ
    • May be repeated once after 20 minutes


  • Pediatrics
    • 0.01mg/kg, not to exceed 0.25mg
    • May be repeated once after 20 minutes


  • Should be administered SQ to the lateral Deltoid area


  • If patient’s condition warrants the administration of IM Epinephrine follow existing COG but remember to:


  • Contact Medical Control prior to administering Epinephrine in patients who are greater than 50 years of age, have a history of cardiac disease, hypertension, or if the patient's heart rate is greater than 150.


Certification Requirements:


  • This medication can only be given by Paramedics and cardiac monitoring is required.


  • Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure. Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations, or other mechanisms as deemed appropriate by the Greenville County EMS system.