Home Drug Guide Arformoterol Tartrate

Drug Guide

Generic Name

Arformoterol Tartrate

Brand Names Brovana

Classification

Therapeutic: Bronchodilator for COPD management

Pharmacological: Beta2-adrenergic agonist

FDA Approved Indications

  • Long-term maintenance treatment of bronchoconstriction in patients with COPD, including chronic bronchitis and emphysema

Mechanism of Action

Arformoterol is a selective beta2-adrenergic agonist that stimulates beta2 receptors in the smooth muscle of the bronchi, leading to relaxation of bronchial smooth muscle and bronchodilation.

Dosage and Administration

Adult: Intravenous: 15 mcg twice daily via nebulization; doses may be adjusted by the healthcare provider.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; dose adjustments based on tolerability and response.

Renal Impairment: No specific adjustment recommended; however, monitor for adverse effects.

Hepatic Impairment: No specific data; use caution and monitor patient response.

Pharmacokinetics

Absorption: Rapid absorption via inhalation administration.

Distribution: Widely distributed; extensive first-pass metabolism for oral equivalent routes (not used orally).

Metabolism: Primarily hepatic; via conjugation and oxidative pathways.

Excretion: Metabolites excreted mainly in the urine.

Half Life: Approximately 6 hours.

Contraindications

  • Hypersensitivity to arformoterol or other components of the formulation.

Precautions

  • Use with caution in patients with cardiac arrhythmias, hypertension, or others sensitive to beta-adrenergic stimulation. Use caution in patients with diabetes or hyperthyroidism. Monitor for paradoxical bronchospasm.

Adverse Reactions - Common

  • Tremor (Very common)
  • Increased heart rate (tachycardia) (Common)
  • Muscle cramps (Uncommon)

Adverse Reactions - Serious

  • Paradoxical bronchospasm (Rare)
  • Cardiac arrhythmias (Uncommon)
  • Hypokalemia (Uncommon)

Drug-Drug Interactions

  • Other beta-agonists, beta-blockers (may diminish effect), MAO inhibitors, tricyclic antidepressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, heart rate, rhythm, and blood pressure before and during administration. Watch for paradoxical bronchospasm.

Diagnoses:

  • Ineffective airway clearance
  • Ineffective breathing pattern

Implementation: Administer via nebulizer as prescribed. Ensure proper inhalation technique. Monitor for adverse reactions.

Evaluation: Assess for improved respiratory function and absence of adverse effects.

Patient/Family Teaching

  • Use as prescribed; do not overuse. Report worsening symptoms or adverse effects. Keep medication out of reach of children.
  • Wash nebulizer mouthpiece and chamber after each use.

Special Considerations

Black Box Warnings:

  • None specifically for arformoterol, but long-acting beta2-agonists carry warnings about increased asthma-related mortality in asthma patients (not applicable for COPD).

Genetic Factors: None established.

Lab Test Interference: Possible effects on potassium levels and blood glucose.

Overdose Management

Signs/Symptoms: Severe tachycardia, hypokalemia, chest pain, tremors, severe hypertension or hypotension.

Treatment: Discontinue drug, provide supportive care, monitor cardiac and respiratory status, administer beta-blockers if necessary (cautiously).

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable under recommended storage conditions for specified shelf life.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.