Suprine

Suprine is a brand name for terbutaline sulfate, a synthetic beta-2 adrenergic receptor agonist. It acts on beta-2 receptors in smooth muscle to increase intracellular cyclic adenosine monophosphate (cAMP), leading to relaxation of bronchial and uterine smooth muscle. This results in bronchodilation and, in obstetrics, tocolysis to suppress preterm labor. Terbutaline has been used in acute relief of bronchospasm in asthma and in obstetric care to delay preterm birth in certain circumstances. It can be given by subcutaneous injection for tocolysis, orally or subcutaneously for asthma, and there are inhaled formulations for bronchodilation.

In clinical practice, terbutaline is considered a short-acting beta-2 agonist for rapid relief of bronchospasm. For chronic asthma management, other inhaled therapies are typically preferred. Regarding obstetric use, terbutaline tocolysis is approached with caution due to safety concerns; many guidelines restrict or discourage its use for delaying labor because of risks to the mother and fetus.

Adverse effects are related to beta-adrenergic stimulation and may include tachycardia, palpitations, tremor, headaches, dizziness, and hyperglycemia, with potential hypokalemia. At higher doses, arrhythmias, hypertension, pulmonary edema, and chest pain have been reported. In pregnancy, fetal tachycardia and metabolic effects are possible. Terbutaline should be used with caution in individuals with cardiovascular disease, diabetes, hypertension, or arrhythmias, and interactions with other sympathomimetics or monoamine oxidase inhibitors should be avoided.

Brand availability and regulatory status for Suprine vary by country, and its use for tocolysis has declined in many regions due to safety concerns. Current dosing and indications should follow local guidelines and product labeling.