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beractant (Survanta)
Tradename: Survanta.
Indications:
1) prevention & treatment of respiratory distress syndrome (RDS) in premature infants
2) prophylactic therapy: low birth weight (< 1250 g) infants
3) treatment of pulmonary aspiration [3]
Dosage:
1) intratracheal administration only
2) instillation through a 5-French end-hole catheter inserted into the infants endotracheal tube
3) administer does in 4 25 mg (1 mL)/kg aliquots
4) each aliquot is administered over 2-3 seconds with the infant in a different position
5) prophylaxis:
a) 100 mg (4 mL)/kg within 15 minutes of birth
b) as many as 4 doses in 1st 48 hours of life
c) doses at least 6 hours apart
Storage:
1) refrigerate
2) protect from light
3) warm prior to administration
a) 20 minutes at room temperature
b) 8 minutes hand held
c) do NOT use artificial warming methods
4) may return warmed, unopened vial within 8 hours to refrigerated storage once
5) do NOT shake
6) swirl gently is settling occurs during storage
Suspension: phospholipids 25 mg/mL suspended in normal saline (8 mL)
Pharmacokinetics:
- elimination: lung
Adverse effects:
1) common (> 10%)
- transient bradycardia
2) less common (1-10%)
- oxygen desaturation
3) uncommon (< 1%)
- vasoconstriction, hypotension, hypertension, pallor, endotracheal tube blockage, hypocarbia, apnea, pulmonary air leaks, pulmonary interstitial emphysema, nosocomial sepsis
General
pulmonary agent
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Deprecated Reference