poractant alfa

poractant alfa /por·ac·tant al·fa/ (por-ak´tant al´fah) an extract of porcine lung surfactant used in the treatment of respiratory distress syndrome of the newborn.

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poractant alfa,

a lung surfactant extract.

indication It is used in the treatment (rescue) of respiratory distress syndrome in premature infants.

contraindication None is currently known.

adverse effects Concurrent illnesses that have occurred during treatment with this drug include pulmonary air leaks, pulmonary interstitial emphysema, apnea, pulmonary hemorrhage, patent ductus arteriosus, intracranial hemorrhage, severe intracranial hemorrhage, necrotizing enterocolitis, posttreatment sepsis, and posttreatment infection. Adverse effects include bradycardia, oxygen desaturation, pallor, vasoconstriction, hypotension, and hypertension.

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poractant alfa

Curosurf

Pharmacologic class: Porcine lung extract

Therapeutic class: Exogenous pulmonary agent

Pregnancy risk category NR

Action

Stabilizes and expands alveoli by reducing their surface tension and replenishing surfactant, preventing alveolar collapse

Availability

Suspension for endotracheal instillation: 120 mg (1.5 ml), 240 mg (3 ml)

⊘Indications and dosages

➣ Respiratory distress syndrome (RDS) in premature infants

Infants: 2.5 ml/kg birth weight endotracheally, with half of dose instilled into each bronchus; up to two subsequent doses of 1.25 ml/kg birth weight at 12-hour intervals may be needed. Maximum dosage is 5 ml/kg (initial dose plus two subsequent doses).

Off-label uses

• Adult RDS caused by viral pneumonia or near-drowning
• Infants with human immunodeficiency virus accompanied by Pneumocystis jiroveci pneumonia

Contraindications

None

Precautions

Use cautiously in:
• bradycardia, crackles, infection
• family history of pork allergy.

Administration

☞ Know that drug should be given only by clinicians experienced in intubation, ventilatory management, and resuscitation of neonates, because it can rapidly affect oxygenation and pulmonary function.
• Give first dose as soon as possible after RDS diagnosis, when patient is on ventilator.
• Be aware that drug is meant for endotracheal use only.
• Before use, slowly warm vial to room temperature and gently turn upside-down to ensure uniform suspension. Don't shake.
• Using large-gauge needle, withdraw entire contents of vial into 3-ml or 5-ml syringe. Attach precut, 8-cm #5 French catheter to syringe. Fill catheter with drug; discard excess drug through catheter so that only prescribed dose remains in syringe.
• Before giving, verify proper placement and patency of endotracheal tube. Make sure catheter doesn't extend beyond endotracheal tube.

Route	Onset	Peak	Duration
Intratracheal	Immediate	3 hr	Unknown

Adverse reactions

CV: transient hypotension and bradycardia

Respiratory: transient endotracheal tube blockage, decreased oxygen saturation, airway obstruction

Interactions

None significant

Patient monitoring

• Monitor vital signs and ECG. Watch for hypotension and bradycardia.
☞ Assess closely for endotracheal tube blockage and proper ventilation.

Patient teaching

• Reassure parents that infant will be monitored closely.