Beractant

INTRODUCTION

Indications

Treatment and prophylaxis of respiratory distress syndrome (RDS, hyaline membrane disease) in premature infants.

Action

Replaces endogenous pulmonary surfactant in premature infants, allowing normal surface activity in alveoli. Consists of natural bovine lung extract. Therapeutic Effects: Decreased incidence, mortality, and complications from RDS.

Adverse Reactions/Side Effects

Resp: oxygen desaturation (as a result of administration process). CV: transient bradycardia.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Monitor oxygen saturation levels following administration. Notify physician or nursing staff immediately about a sudden decrease is oxygen saturation.

• Assess heart rate, and report a sustained decrease in heart rate (bradycardia).

Interventions

• When indicated, implement chest physical therapy interventions such as positioning, suctioning, and chest percussion/vibration to maintain respiratory function and augment drug effects in premature infants.

Pharmacokinetics

Absorption: Administered directly to site of action. Systemic absorption not known.

Distribution: Rapidly distributes to lung tissue.

Metabolism and Excretion: Enters surfactant pathways in which recycling and reutilization occur.

Half-life: Unknown.

Contraindications/Precautions

Contraindicated in: No known contraindications.

Use Cautiously in: No known cautions. Nosocomial infections may be more common.

Interactions

Drug-Drug: None known.

Route/Dosage

Intratracheal (Infants, Premature): 100 mg phospholipids/kg birth weight (4 mL/kg birth weight); 4 doses may be given in first 48 hr of life, no closer than q 6 hr apart.

Availability

Intratracheal suspension: 25 mg phospholipid/mL—4-mL and 8-mL vials.