【药理毒理】
本品是一种肾上腺素能受体激动剂，可选择性激动ß2受体，从而松弛支气管平滑肌，抑制内源性致痉挛物质的释放及内源性介质引起的水肿；提高支气管黏膜纤毛上皮细胞廓清能力，也可松弛子宫平滑肌．

【药代动力学】    
口服生物利用度为 15土 6％，约30分钟出现平喘作用．有效血药浓度为3ug／ml, 血浆蛋白结合率约为25％．2—4小时作用达高峰，持续4—7小时。表现分布容积（Vd）为1.4士 0.4L/kg。

【适应症】    
平喘药．适用于支气管哮喘，慢性支气管炎、肺气肿和其它伴有支气管痉挛的肺部疾病．

【用法用量】   
片剂：口服。给药剂量应个体化    
成人：开始1－2周，一次1.25mg（半片）
          一日2—3次。以后可加至一次2.5mg（一片）,一日3次．    
儿童：按体重一次0.065mg/kg(但一次总量不应超过1.25mg),一日3次．
喷雾剂：作为初步治疗，吸入性支气管扩张药应需要时用，用量因人而异。成人及12岁以上的儿童：每6小时吸一次（0.5mg）用作需要性治疗或经常性维持治疗。严重时，一天最多不得超过12剂量。 临床研究证实博利康尼都保在3岁以下小孩同样有效且安全，但操作吸入器时可能有困难。

【不良反应】    
不良反应的程度取决于剂量和给药途径从小剂量逐渐加至冶疗量常能减少不良反应。    
报告的有震颤、头痛、恶心、强直性痉挛、心动过速和心悸 这些均为拟交感胺类药的作用特点。这些不良反应若出现，大多在开始用药1—2周内自然消失。    
可能会发生皮疹和荨麻疹不良反应、亦发现过睡眼失调和行为失调，如易激动、多动、坐立不安等．

【禁忌】   
对本品过敏者禁用。

【注意事项】   
1.少数病例有手指震颤、头痛、心悸及胃肠道障碍、口服5mg时,手指震颤发生率可达20％－33％。   
2.甲状腺功能亢进、冠心病、高血压、糖尿病患者慎用．   
3.大剂量应用可使有癫痫病史的患者发生酮症酸中毒．   
4.长期应用可产生耐受牲，疗效降低．
5.ß2受体激动剂可能会引起低钾血症。当与黄嘌呤衍生物、类固醇、利尿药合用及缺氧都可能增加低钾血症的发生，因此，在这种情况下需监测血清钾的浓度。

【孕妇及哺乳期妇女用药】   
1.对人或动物未见致畸作用，但建议在怀孕的前三个月内慎用。   
2.特布他林可随乳汁分泌，但在治疗剂量时不会对乳儿产生不良影响。   
3.因可松弛子宫平滑肌，所以可抑制孕妇的子宫活动能力及分娩，应慎用。

【儿童用药】见【用法用量】．

【药物相互作用】   
1.并用其他肾上腺素受体激动剂可使疗效增加。但不良反应也可能加重。   
2.并用茶碱类药可增加疗效，但心悸等不良反应也可能加重。   
3.非选择性ß受体阻滞剂(包括滴眼剂)可部分或全部抑制该药的作用．   
4.ß2受体激动剂可能会引起低钾血症，同时使用黄嘌呤衍生物、类固醇和利尿剂会加重这种作用，见【注意事项】．

【药物过量】   
1.可能的症状和体征：头痛、焦虑、震颤、强直性肌肉痉挛、心悸和心律不齐。有时可能会产生血压下降。   
2.化验室检查：有时会产生高血糖和乳酸过多症状、ß2受体激动剂可能因促进钾的重新分布而导致低钾血症。
3.药物过量的治疗：通常无需治疗、如果怀疑服用大量的硫酸特布他林，可考虑采取下列措施：   
    活性炭灌胃冲洗、检测酸碱平衡、血糖和电解质。监测心率、心律和血压、纠正代谢异常．建议用心脏选择性的ß受体阻滞剂（如美托洛尔）来治疗心律失常所引起的血流动力学异常改变。但应慎用ß受体阻滞剂，因其可能会诱导支气管阻塞、如ß2受体介导的外周血管阻力减小导致血压阴显下降，则应给予扩容剂．

【贮藏】   
室温,密封保存．

【原产地英文商品名】BRICANYL SYRUP 0.3mg/ml 100mls/bottle
【原产地英文药品名】TERBUTALINE SULFATE
【中文参考商品译名】BRICANYL糖浆 0.3毫克/毫升 100毫升/瓶
【中文参考药品译名】硫酸特布他林
【中文参考化合物名称】（+）α－［（叔丁氨基）甲基］－3，5-二羟基苯甲醇硫酸盐（2：1）
【生产厂家中文参考译名】River East Supplies Ltd
【生产厂家英文名】River East Supplies Ltd

Bricanyl (Terbutaline Sulfate)

Bricanyl Information
Bricanyl is a drug classified as a bronchodilator. It widens the passage of air to facilitate better breathing.

Bricanyl Indications
Bricanyl is used to treat asthma, bronchospasms characterized by wheezing and shortness of breath.

Bricanyl is also prescribed for the treatment of bronchitis and emphysema.

Bricanyl works by relaxing the muscles in the aerial passages to induce proper breathing.

Bricanyl Warnings
For asthmatic patients, when there is an increase in your demand for Bricanyl medication and if your bronchospasms or wheezing is not easily controlled by your normal dose and if you feel that there is a need for an increase dosage, beware as this may signify a worsening condition of asthma or an asthma attack.

Inform your doctor if you have any of the following medical conditions because Bricanyl may not be prescribed if you have any of the following medical problems:
•Heart diseases
•Diabetes
•Liver problems
•Seizures or epilepsy
•hyperthyroidism
•Kidney diseases

If you have any of these, your doctor may advise you to stop taking Bricanyl or to lower your dosage depending on his/her assessment of your situation.

Bricanyl belongs to the drugs in Pregnancy B. These drugs are not known to be harmful to the unborn baby when taken by pregnant women but it still best that you consult your doctor first before taking Bricanyl if you are pregnant or planning to become pregnant. However, the active ingredient of Bricanyl which is terbutaline passes into the breast milk of nursing mothers. Do not breast feed without first talking to your doctor.

Always do other necessary exercises to improve your respiratory condition so that faster healing will commence.

Avoid strenuous activities and doing exercises in cold environment as these may worsen your condition.

Also avoid exposure to allergens that may cause asthma such as smoking and breathing of dust.

Bricanyl Intake Guidelines
Bricanyl should be taken exactly as directed by your doctor. Never deviate from your doctor’s instructions regarding your intake.

Each dose of Bricanyl must be taken with a full glass of water. If its possible not to miss a dose, do not miss a dose as taking Bricanyl regularly will promote faster recovery from your illness.

If you feel that you do not anymore respond well to your normal dosage and require a higher dosage in order to feel relief, this can signify an upcoming asthma attack or the worsening of your asthma condition and even if you feel that your dosage should be higher than what you are taking, never attempt to scale a dose for yourself. Do not take larger doses aside from the dose prescribed by your doctor.

Bricanyl Dosage
Lung functions test and other medical evaluations may be done before you are advised to take Bricanyl in order to determine the exact dose. The dosage of Bricanyl intake can only be effectively determined by your doctor. Follow your doctor’s prescribed dosage of Bricanyl at all times.

Bricanyl Overdose
The most prevalent signs of overdose are tremors and an irregular heartbeat. Other symptoms of Bricanyl overdose are:
•Chest pains
•Angina
•Seizures
•Weakness
•Nausea
•Vomiting

If any of these symptoms is present and overdose is suspected, immediately seek medical attention.

Bricanyl Missed Dose
Do not take double doses of this medicine to make up for a missed dose. If you happen to miss a dose, take it as soon as you remember provided that it is not yet near the time for the next dose. However, if it is already near the time for the next dose, entirely skip that dose you missed and proceed with your normal schedule of intake.

Bricanyl Side Effects
Allergic reactions may occur when taking Bricanyl. An Allergic reaction is characterized by hives, swelling of lips, throat and mouth, and throat constriction.

Other side effects may also occur such as:
•Tremors
•Headache
•Insomnia
•Nervousness
•Palpitations
•Heavy sweating
•Nausea and vomiting
•Dry mouth
•Dizziness

Other side effects not mentioned above may also occur. Talk to your doctor if begin to feel unusual symptoms that only occurred when started taking Bricanyl.

Bricanyl Drug Reactions
Certain drugs may not work well with Bricanyl such as:
•Beta blockers
•Tricyclic antidepressants
•MAOI
•Other bronchodilators that are in an inhaled form
•Caffeine
•Diet pills
•Decongestants

If you are taking any of the mentioned drugs, you may be advised by your doctor to stop taking Bricanyl or prescribe you a milder dose.