Salbutamol tocolysis

>  Continuous CTG during procedure

Preparation

>  Exclude a history of maternal cardiac disease or arrhythmia / untreated thyrotoxicosis

Dosage and administration

>  Obstetric salbutamol:  5 mL ampoule 5 mg / 5 mL    

>  Using a 1 mL syringe, draw up 0.25 mL (250 micrograms) of salbutamol

>  Add to a 10 mL syringe and make up to 10 mL with sodium chloride 0.9 % (25 micrograms per mL)

>  Give intravenous salbutamol slowly in 50 microgram boluses up to 250 micrograms in total (often 100 micrograms will be sufficient)

>  Ensure monitoring of maternal pulse whilst bolus doses are administered 

>  Stop IV administration if maternal pulse > 140

Side effects

>  Fetal and maternal tachycardia, maternal hypotension, ventricular ectopics, supra-ventricular tachycardia, ventricular fibrillation, pulmonary oedema, hypoxia – secondary to increased oxygen demands + / - fluid shift in lungs, hyperglycaemia 

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