Home Drug Guide Zafirlukast

Drug Guide

Generic Name

Zafirlukast

Brand Names Accolate

Classification

Therapeutic: Antiasthmatic, Leukotriene Receptor Antagonist

Pharmacological: Leukotriene receptor antagonist

FDA Approved Indications

  • Prevention and chronic treatment of asthma in adults and children 5 years and older

Mechanism of Action

Zafirlukast blocks leukotriene receptors (cysLT1) on airway and inflammatory cells, reducing bronchoconstriction, airway edema, and inflammatory responses in asthma.

Dosage and Administration

Adult: 20 mg orally twice daily, at least 1 hour before or 2 hours after meals.

Pediatric: 20 mg orally twice daily for children 5-11 years old; doses should be administered consistently.

Geriatric: No specific dosage adjustment needed, but renal and hepatic function should be monitored.

Renal Impairment: Use with caution; no specific dose adjustment recommended, but monitoring is advised.

Hepatic Impairment: Use with caution; lower initial doses may be considered, and liver function should be monitored.

Pharmacokinetics

Absorption: Well absorbed with oral administration.

Distribution: Bind to plasma proteins about 99%; volume of distribution approximately 10 L.

Metabolism: Metabolized in the liver via the cytochrome P450 enzyme system, mainly CYP2C9 and CYP3A4.

Excretion: Primarily excreted in feces; minimal urinary excretion.

Half Life: Approximately 10 hours.

Contraindications

  • Hypersensitivity to zafirlukast or any component of the formulation.

Precautions

  • Use with caution in patients with hepatic impairment, as it may increase drug levels. Not recommended for acute asthma attacks. Monitor liver function periodically.

Adverse Reactions - Common

  • Headache (Common)
  • Pharyngitis (Common)
  • Dizziness (Less common)

Adverse Reactions - Serious

  • Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis) (Rare)
  • Hepatic dysfunction (hepatitis, elevated liver enzymes) (Rare)
  • Allergic granulomatous vasculitis (Rare)

Drug-Drug Interactions

  • Concurrent use with warfarin may increase bleeding risk. Caution with inhibitors or inducers of CYP450 enzymes.
  • drug_food:
  • drug_herb:

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, liver function tests periodically, and for signs of allergic reactions.

Diagnoses:

  • Impaired airway clearance related to bronchospasm.
  • Risk for hepatic injury.

Implementation: Administer as prescribed, preferably on an empty stomach. Educate patient on signs of liver dysfunction or allergic reactions.

Evaluation: Assess for reduction in asthma symptoms, decreased use of rescue inhalers, and absence of adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed, even when asymptomatic.
  • Report any signs of liver problems (jaundice, dark urine) or allergic reactions.
  • Carry medical identification indicating use of zafirlukast.

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May elevate serum levels of liver enzymes, which can interfere with diagnoses of hepatic conditions.

Overdose Management

Signs/Symptoms: Nausea, vomiting, abdominal pain, somnolence.

Treatment: Supportive care; no specific antidote available. Consider activated charcoal if ingestion was recent.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 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.