Beractant

Trade Names:Survanta- Suspension 25 mg phospholipids per mL suspended in 0.9% sodium chloride solution. With 0.5 to 1.75 mg triglycerides, 1.4 to 3.5 mg free fatty acids, and less than 1 mg protein per mL.

Pharmacology

Replaces deficient endogenous pulmonary surfactant and restores surface activity of lung.

Indications and Usage

Prevention and treatment (“rescue”) of neonatal respiratory distress syndrome (RDS) in premature infants.

Contraindications

Standard considerations.

Dosage and Administration

Intratracheal

25 mg/kg/instillation for 4 instillations (total dose of 100 mg/kg is administered in 4 quarter doses); dose is started within 15 min of birth.

25 mg/kg/instillation for 4 instillations (total dose 100 mg/kg). May be repeated for continued or progressive RDS.

General Advice

• Warm medication by allowing it to stand at room temperature for 20 min or in hand for 8 min. Do not use artificial warming methods.
• If settling has occurred, swirl gently; do not shake.
• Before administering, assure proper placement and patency of endotracheal (ET) tube. If suctioning is required, allow patient to stabilize before administering.
• Instill through small (5 Fr) catheter inserted into ET tube with tip above carina. Do not instill into main stem bronchus. Attach catheter to syringe. Fill with medication and discard any excess through catheter to ensure that total dose to be given remains in syringe. After each quarter dose, remove catheter and mechanically ventilate patient for 30 sec. Continue procedure until total dose is achieved. Administer each quarter dose with infant in different position.
• Avoid suctioning patient for 1 h after administration unless airway is obstructed.

Storage/Stability

Store unopened vials under refrigeration and protect from light. Warmed unopened vials (under 8 h) can be returned to refrigerator for future use. Drug should not be warmed and refrigerated more than once. Discard any open vials.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Intracranial hemorrhage.

Precautions

Administer drug only by trained personnel in a closely supervised setting.

Nosocomial sepsis

Occurred in controlled clinical trials.

Overdosage

Symptoms

Acute airway obstruction (based on animal studies).

Patient Information

• Advise family of infant's condition and offer frequent updates.
• Encourage active family participation in care whenever possible.
• Provide emotional support; offer hospital services and support groups.

Copyright © 2009 Wolters Kluwer Health.