Pronunciation |
(kole FOS er il PALM i tate) |
U.S. Brand Names |
Exosurf® Neonatal™ |
Generic Available |
No |
Synonyms |
Dipalmitoylphosphatidylcholine; DPPC; Synthetic Lung Surfactant |
Pharmacological Index |
Lung Surfactant |
Use |
Neonatal respiratory distress syndrome: Rescue therapy: Treatment of infants with RDS based on respiratory distress not attributable to any other causes and chest radiographic findings consistent with RDS |
Warnings/Precautions |
Pulmonary hemorrhaging may occur especially in infants <700 g. Mucous plugs may have formed in the endotracheal tube in those infants whose ventilation was markedly impaired during or shortly after dosing. If chest expansion improves substantially, the ventilator PIP setting should be reduced immediately. Hyperoxia and hypocarbia (hypocarbia can decrease blood flow to the brain) may occur requiring appropriate ventilator adjustments. |
Adverse Reactions |
1% to 10%: Respiratory: Pulmonary hemorrhage, apnea, mucous plugging, decrease in transcutaneous O2 of >20% |
Stability |
Reconstituted suspension should be used immediately and unused portion discarded; store at room temperature of 15°C to 30°C (59°F to 86°F); do not refrigerate |
Mechanism of Action |
Replaces deficient or ineffective endogenous lung surfactant in neonates with respiratory distress syndrome (RDS) or in neonates at risk of developing RDS; reduces surface tension and stabilizes the alveoli from collapsing |
Pharmacodynamics/Kinetics |
Absorption: Intratracheal: Absorbed from the alveolus Metabolism: Catabolized and reutilized for further synthesis and secretion in lung tissue |
Usual Dosage |
For intratracheal use only. Neonates: Rescue treatment: Administer 5 mL/kg (as two 2.5 mL/kg half-doses) as soon as the diagnosis of RDS is made; the second 5 mL/kg (as two 2.5 mL/kg half-doses) dose should be administered 12 hours later |
Administration |
For intratracheal administration only. Suction infant prior to administration; inspect solution to verify complete mixing of the suspension. Administer via sideport on the special ETT adapter without interrupting mechanical ventilation. Administer the dose in two 2.5 mL/kg aliquots. Each half-dose is instilled slowly over 1-2 minutes in small bursts with each inspiration. After the first 2.5 mL/kg dose, turn the infant's head and torso 45° to the right for 30 seconds, then return to the midline position and administer the second dose as above. Following the second dose, turn the infant's head and torso 45° to the left for 30 seconds and return the infant to the midline position. |
Monitoring Parameters |
Continuous EKG and transcutaneous O2 saturation should be monitored during administration; frequent ABG sampling is necessary to prevent postdosing hyperoxia and hypocarbia |
Dental Health: Local Anesthetic/Vasoconstrictor Precautions |
No information available to require special precautions |
Dental Health: Effects on Dental Treatment |
No effects or complications reported |
Nursing Implications |
Continuous EKG and transcutaneous O2 saturation should be monitored during administration; frequent ABG sampling is necessary to prevent postdosing hyperoxia and hypocarbia |
Dosage Forms |
Powder for injection, lyophilized: 108 mg (10 mL) |
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