Drug Guide
Poractant Alfa
Classification
Therapeutic: Respiratory therapy - surfactant replacement in neonates
Pharmacological: Pulmonary surfactant
FDA Approved Indications
- Treatment of neonatal respiratory distress syndrome (NRDS) in preterm infants
Mechanism of Action
Poractant Alfa is a natural surfactant that reduces surface tension in the alveoli, thereby improving lung compliance and gas exchange in neonates with surfactant deficiency.
Dosage and Administration
Adult: Not indicated for adult use
Pediatric: Administer via intratracheal instillation as prescribed. Typical dose varies, usually a dose of 2.5 mL/kg (120 mg/kg) is given initially, with additional doses if necessary.
Geriatric: Not applicable (specifically used in neonates)
Renal Impairment: No dose adjustment required, but monitoring advised
Hepatic Impairment: No specific data; use caution and monitor as appropriate
Pharmacokinetics
Absorption: Not applicable; administered directly into the lungs
Distribution: Lung tissue
Metabolism: Metabolized locally in the lungs
Excretion: Pulmonary clearance over time, excreted via mucociliary pathways and swallowed
Half Life: Varies; typically cleared from alveoli in hours to days
Contraindications
- Known hypersensitivity to surfactant preparations or any component of Curosurf
Precautions
- Use with caution in infants with congenital heart disease or persistent pulmonary hypertension. Ensure proper dosing and administration by trained personnel.
Adverse Reactions - Common
- Chronic lung disease (bronchopulmonary dysplasia) (Rare)
- Air leak syndromes (pneumothorax, pneumomediastinum) (Rare)
Adverse Reactions - Serious
- Anaphylactic reactions (Very rare)
- Pulmonary hemorrhage (Rare)
Drug-Drug Interactions
- None established
Drug-Food Interactions
- None known
Drug-Herb Interactions
- None known
Nursing Implications
Assessment: Monitor for improvement in oxygenation, ventilation parameters, and signs of adverse reactions.
Diagnoses:
- Impaired gas exchange related to surfactant deficiency
- Risk for respiratory distress
Implementation: Administer via endotracheal tube as prescribed, maintain sterile technique, monitor vital signs and oxygenation.
Evaluation: Assess for improved lung compliance and oxygenation, monitor for adverse reactions.
Patient/Family Teaching
- Explain the purpose of surfactant therapy and possible side effects.
- Assist family in understanding the procedure and potential risks.
- Advise on signs of respiratory distress or adverse reactions to watch for after administration.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: None specific
Lab Test Interference: None known
Overdose Management
Signs/Symptoms: Respiratory deterioration, oxygenation failure
Treatment: Supportive care; ensure adequate ventilation; no specific antidote; treat symptoms accordingly.
Storage and Handling
Storage: Store unopened vials at 2°C to 8°C (36°F to 46°F). Do not freeze.
Stability: Stable until the expiry date when stored properly. Use immediately after opening or discard if not used promptly.