Muterol

• Muterol is indicated for
• Bronchial asthma
• Chronic bronchitis
• Emphysema

Other lung diseases where bronchospasm is a complicating factor.

Bambuterol, a prodrug of terbutaline, is a long acting ß2 adrenergic receptor agonist used in the treatment of asthma. Bambuterol is an adrenergic ß2 receptor agonist which predominantly stimulates ß2 receptor, thus producing relaxation of bronchial smooth muscle, inhibition of release of endogenous spasmogens, inhibition of edema caused by endogenous mediators & increased mucocilliary clearance.

Children 2-5 years : The recommended normal dose 10 mg (10 ml syrup). Children 6-12 years : The recommended normal dose 10 mg (10 ml syrup). The dose may be increased to 20 mg. Adult : The recommended initial dose 10 mg. The dose may be increased to 20 mg after 1-2 weeks depending on the clinical effect.

Succinylcholin, MAOIs (monoamine oxidase inhibitors), ß2-blockers, corticosteroids, diuretics, muscle relaxants, sympathomimetic xanthine derivatives.

Hepatic impairment, liver cirrhosis or severely impaired liver function.

Fatigue, nausea, palpitation, headache, dizziness & tremor.

Although no teratogenic effects have been observed in animal after administration of bambuterol, caution is recommended during first trimester of pregnancy. It is not known whether bambuterol or intermediary metabolites pass over to breast milk, so caution is recommended if bambuterol is administered to patients who are breast feeding. Terbutalin passes over to breast milk but an influence on the child is unlikely with therapeutic doses. Transient hypoglycemia has been reported in new born pre-term infants after maternal ß2 agonist treatment.

Dose should be reduced in patients with severely impaired renal function, patiensts with genetic deficiencies of plasma cholineterase, patient with severe ischemic heart disease.

No case of bambuterol overdosage has yet been reported in human. It is likely that overdosing would result in high levels of terbutaline & therefore the same symptoms & signs may include: headache, anxiety, tremor, nausea, tonic muscle cramps, palpitations, tachycardia & cardiac arrythmias. A fall in blood pressure sometimes occurs after terbutaline overdosage. Laboratory findings: hyperglycaemia and lactacidosis sometimes occur. High doses of ß2-agonists may cause hypokalemia as a result of redistribution of potassium.

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.