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Pronunciation |
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(kole
FOS er il PALM i
tate) |
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U.S. Brand
Names |
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Exosurf®
Neonatal™ |
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Generic
Available |
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No |
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Synonyms |
|
Dipalmitoylphosphatidylcholine; DPPC; Synthetic Lung Surfactant |
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Pharmacological Index |
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Lung Surfactant |
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Use |
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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 |
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Warnings/Precautions |
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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. |
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Adverse
Reactions |
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1% to 10%: Respiratory: Pulmonary hemorrhage, apnea, mucous plugging,
decrease in transcutaneous O2 of >20% |
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Stability |
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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 |
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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 |
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Pharmacodynamics/Kinetics |
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Absorption: Intratracheal: Absorbed from the alveolus
Metabolism: Catabolized and reutilized for further synthesis and secretion in
lung tissue |
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Usual Dosage |
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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 |
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Administration |
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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. |
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Monitoring
Parameters |
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Continuous EKG and transcutaneous O2 saturation should be
monitored during administration; frequent ABG sampling is necessary to prevent
postdosing hyperoxia and hypocarbia |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Nursing
Implications |
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Continuous EKG and transcutaneous O2 saturation should be
monitored during administration; frequent ABG sampling is necessary to prevent
postdosing hyperoxia and hypocarbia |
|
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Dosage Forms |
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Powder for injection, lyophilized: 108 mg (10
mL) |
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Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
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