26 . September , 2018 - Wednesday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Calfactant

Big Image Pronouncation: (Kal-FACK-tant)
Class: Lung surfactant

Trade Names:
Infasurf
- Suspension, intratracheal 35 mg phospholipids/mL suspended in sodium chloride 0.9% solution and 0.65 mg proteins. With 26 mg phosphatidylcholine, of which 16 mg is disaturated phosphatidylcholine. Also includes 0.26 mg of SP-B.

Mechanism of Action

Pharmacology

Extract of natural surfactant from calf lungs that restores lung surfactant in premature infants with lung surfactant deficiency causing respiratory distress syndrome (RDS).

Indications and Usage

RDS in premature infants younger than 29 wk of gestational age at high risk for RDS and for the treatment rescue of premature infants younger than 72 h of age who develop RDS and require endotracheal intubation.

Contraindications

None well documented.

Dosage and Administration

Newborn Infants

Intratracheal 3 mL/kg body weight at birth. Dose may be repeated every 12 h for total of 3 doses.

General Advice

  • Discard any unused drug after opening.
  • For intratracheal administration only. Administer through an endotracheal tube. Draw dose into a syringe from the single-use vial using a 20-gauge or larger needle; avoid excessive shaking and foaming.
  • Do not shake, dilute, or sonicate. If settling has occurred, swirl or roll gently.
  • Visible flecks in the suspension and foaming at the surface are normal and warming before administration is not necessary.
  • Before administration, ensure proper placement and patency of endotracheal tube. If suctioning is required, be sure patient is adequately oxygenated and stabilized before administering.
  • Administer calfactant via the intratracheal route through a side-port adapter into the endotracheal tube. Two qualified medical professionals experienced in the care of high-risk infants should facilitate the dosing: one to instill the calfactant and the other to monitor the patient and assist in positioning. After each aliquot is instilled, position the infant on the right or left side to facilitate distribution.
  • Calfactant also can be administered through a 5 French feeding catheter inserted into the endotracheal tube with the tip above the carina. Do not instill into the main stem bronchus. Attach the catheter to syringe. Fill with medication and discard any excess through catheter to ensure the total dose to be given remains in syringe. Instill the total dose in 4 equal aliquots with the catheter removed between each of the instillations and mechanical ventilation resumed for 30 sec to 2 min. Administer each of the aliquots in 1 of 4 different positions (eg, prone, supine, right, left lateral) to facilitate even distribution of the surfactant. Continue the procedure until the total dose is achieved.
  • Avoid suctioning patient for 1 h after administration unless airway obstruction is present.

Storage/Stability

Refrigerate (36° to 46°F) and protect from light. Unopened, unused vials that have been warmed to room temperature can be returned to refrigerator within 24 h for future use. Avoid repeated warming.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Bradycardia.

Respiratory

Cyanosis; airway obstruction.

Miscellaneous

Reflux of surfactant into endotracheal tube; requirement for manual ventilation; reintubation.

Precautions

Monitor

Lung sounds

Monitor lung sounds carefully for any changes (eg, moist rales).

Oxygen therapy/Ventilatory support

Calfactant can rapidly improve oxygenation and lung compliance; monitor patients carefully so that oxygen therapy and ventilatory support can be modified in response to changes in respiratory status. Monitor respiratory and oxygen status closely following administration and adjust oxygen therapy and ventilator pressures appropriately.

Oxygen and carbon dioxide levels

Continually monitor oxygen and carbon dioxide levels. If oxygen saturation decreases or bradycardia develops, discontinue administration until the infant is stabilized.


Administration

Administer calfactant intratracheally through an endotracheal tube and only in an acute care unit organized, staffed, equipped, and experienced with intubation, ventilation management, and general care of newborns with, or at risk for, RDS. During administration of calfactant liquid suspension into the airway, monitor the infant for bradycardia, reflux of calfactant into the endotracheal tube, airway obstruction, cyanosis, dislodgment of the endotracheal tube, or hypoventilation. If any of these events occur, interrupt administration and stabilize the infant's condition using appropriate interventions before resuming administration.

Dosing precautions

If any of the following situations occur while administering calfactant, interrupt administration and stabilize the infant's condition before resuming administration: bradycardia; reflux of calfactant into endotracheal tube; airway obstruction; cyanosis; hypoventilation; dislodgment of endotracheal tube.

Endotracheal suctioning/Reintubation

Be prepared for possible endotracheal suctioning or reintubation if signs of airway obstruction are present during administration.

Overdosage

Symptoms

Overloading of the lungs with isotonic solution.

Patient Information

  • Provide family with patient information leaflet.
  • Offer frequent updates to the parents and other family members on the infant's condition.
  • Encourage whole family participation in the infant's care whenever possible.
  • Provide emotional support.
  • Make appropriate referrals to hospital services and support groups.

Recent Drug Updates at DrugIndexOnline:





Cordran Cream Cordran Cream
Generic Name: Flurandrenolide Cream and Ointment (flure-an-DREN-oh-lide) Brand Name: Cordran SP and CordranCordran Cream is used for:Treating inflammation and itching due to certain skin conditions. It may also be used for other conditions as determined by your doctor. Cordran Cream is a topica more...

Cytomel Cytomel
Generic Name: Liothyronine Tablets (lye-oh-THYE-roh-neen) Brand Name: CytomelCytomel , used alone or with other medicines, should not be used to treat obesity or for weight loss. Large doses may cause serious or life-threatening situations, particularly when used with other medicines that reduce more...

Desquam-X 5 Wash Topical Desquam-X 5 Wash Topical
Some commonly used brand names are: In the U.S.— Acne-Aid Vanishing Cream Acne-Aid Aqua Gel Ambi 10 Acne Medication Benoxyl 5 Lotion Benoxyl 10 Lotion Benzac AC 21/2 Gel Benzac AC 5 Gel Benzac AC 10 Gel Benzac AC Wash 21/2 Benzac AC Wash 5 Benzac AC Wash 10 Benzac 5 Gel Benzac 10 Gel Benz more...

Fluticasone Topical Fluticasone Topical
Some commonly used brand names are: In the U.S.— Alphatrex 3 Aristocort 20 Aristocort A 20 Betatrex 3 Beta-Val 3 Bio-Syn 9 Cordran 11 Cordran SP 11 Cormax 4 Cutivate 12 Cyclocort 1 Delta-Tritex 20 Dermabet 3 Dermatop 19 Diprolene 3 Diprolene AF 3 Diprosone 3 Elocon 18 Florone 7 Florone E more...

FML Forte FML Forte
Generic Name: fluorometholone Dosage Form: Ophthalmic suspension, usp 0.25% sterile FML Forte Description FML Forte® sterile ophthalmic suspension is a topical anti-inflammatory product for ophthalmic use. Chemical Name: Fluorometholone: 9-Fluoro-11β, 17-dihydroxy-6α-methylpregna- more...

Ledercillin VK Ledercillin VK
Some commonly used brand names are: In the U.S.— Amoxil 1 Bactocill 11 Beepen-VK 13 Betapen-VK 13 Bicillin L-A 12 Cloxapen 5 Crysticillin 300 A.S. 12 Dynapen 6 Dycill 6 Geocillin 4 Geopen 4 Ledercillin VK 13 Mezlin 9 Nafcil 10 Nallpen 10 Omnipen 2 Omnipen-N 2 Pathocil 6 Pentids 12 Pen Vee more...

Propafenone Propafenone
Pronouncation: (proe-pa-FEEN-one) Class: Antiarrhythmic agent Trade Names: Rythmol - Tablets, immediate release 150 mg - Tablets, immediate release 225 mg - Tablets, immediate release 300 mg - Capsule, extended release 225 mg - Capsule, extended release 325 mg - Capsule, extended release 425 mg Mec more...

Propranolol and Hydrochlorothiazide Propranolol and Hydrochlorothiazide
Some commonly used brand names are: In the U.S.— Corzide 40/5 4 Corzide 80/5 4 Inderide 6 Inderide LA 6 Lopressor HCT 3 Tenoretic 50 1 Tenoretic 100 1 Timolide 10-25 7 Ziac 2 In Canada— Corzide 4 Inderide 6 Tenoretic 1 Timolide 7 Viskazide 5 Note: For quick reference, the fo more...