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.