Severe cases: Gastric lavage, administration of activated charcoal, (where suspected that significant amounts have been swallowed). Determination of acid-base balance, blood sugar and electrolytes, particularly serum potassium levels. Monitoring of heart rate and rhythm and blood pressure. Metabolic changes should be corrected. A cardioselective beta-blocker (e.g. metoprolol) is recommended for the treatment of arrhythmias causing haemodynamic deterioration. The beta-blocker should be used with care because of the possibility of inducing bronchoconstriction: use with caution in patients with a history of bronchospasm. If the beta-mediated reduction in peripheral vascular resistance significantly contributes to the fall in blood pressure, a volume expander should be given.. Bricanyl should be used with caution in patients receiving other sympathomimetics. Halogenated anaesthetics Halothane anaesthesia should be avoided during Beta 2 -agonists treatment, since it increases the risk of cardiac arrhythmias.. PS09719 Package leaflet: Information for the user Bricanyl® Respules® 2.5 mg/ml Nebuliser Solution terbutaline sulfate Read all of this leaflet carefully before you start using this.