PORACTANT ALPHA

PORACTANT ALPHA
(por-act'ant)
Curosurf
Classifications: lung surfactant;
Therapeutic: lung surfactant

Prototype: Beractant

Availability

120 mg/1.5 mL, 240 mg/3 mL vials

Action

Lung surfactant obtained from minced porcine lungs. Endogenous pulmonary surfactant lowers the surface tension on alveoli surfaces during respiration, and stabilizes the alveoli against collapse at resting pressures.

Therapeutic Effect

Alleviates respiratory distress syndrome (RDS) in premature infants caused by deficiency of surfactant.

Uses

Treatment (rescue) of respiratory distress syndrome in premature infants.

Contraindications

Hypersensitivity to porcine products or poractant alpha.

Cautious Use

Infants born >3 wk after ruptured membranes; intraventricular hemorrhage of grade III or IV; major congenital malformations; nosocomial infection; pretreatment of hypothermia or acidosis due to increased risk of intracranial hemorrhage; lactation.

Route & Dosage

Respiratory Distress Syndrome
Neonate: Intratracheal 2.5 mL/kg birth weight, may repeat with 1.25 mL/kg q12h x 2 more doses if needed (max: 5 mL/kg)

Administration

Note: Correction of acidosis, hypotension, anemia, hypoglycemia, and hypothermia is recommended prior to administration of poractant alfa.

Intratracheal
  • Warm vial slowly to room temperature; gently turn upside down to form uniform suspension, but do NOT shake.
  • Withdraw slowly the entire contents of a vial (concentration equals 80 mg/mL) into a 3 or 5 mL syringe through a large gauge (>20 gauge) needle.
  • Attach a 5 French catheter, precut to 8 cm, to the syringe.
  • Fill the catheter with poractant alfa and discard excess through the catheter so that only the total dose to be given remains in the syringe.
  • Refer to specific instruction provided by manufacturer for proper dosing technique. Follow instructions carefully regarding installation of drug and ventilation of infant. Note that catheter tip should not extend beyond distal tip of endotracheal tube.
  • Store refrigerated at 2°–8° C (36°–46° F) and protect from light. Do not shake vials. Do not warm to room temperature and return to refrigeration more than once.

Adverse Effects (≥1%)

CV: Bradycardia, hypotension. Respiratory: Intratracheal tube blockage, oxygen desaturation.

Pharmacokinetics

Not studied.

Nursing Implications

Assessment & Drug Effects

  • Stop administration of poractant alfa and take appropriate measures if any of the following occur: Transient episodes of bradycardia, decreased oxygen saturation, reflux of poractant alfa into endotracheal tube, or airway obstruction. Dosing may resume after stabilization.
  • Do not suction airway for 1 h after poractant alfa instillation unless there is significant airway obstruction.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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