Brethaire (terbutaline).' Novartis Pharmaceuticals, East Hanover, NJ. The recommended dosages should not be exceeded. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. However, beta-2-selectivity is not absolute and can be lost with larger doses. Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. Applies to: Hyperthyroidism, Heart Disease, Hypertension Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave prolongation of the QT interval ST segment depression). Moderate Beta- 2 adrenergic bronchodilators (Includes salmeterol) ↔ cardiovascular Moderate Potential Hazard, Moderate plausibility.
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