Calfacta

Details About Generic Salt ::  Calfacta

Main Medicine Class::    

(Kal-FACK-tant)
Infasurf
Class: Lung surfactant

 

Drugs Class ::

 Action Extract of natural surfactant from calf lungs that restores lung surfactant in premature infants with lung surfactant deficiency causing respiratory distress syndrome (RDS).

Indications for Drugs ::

 Indications RDS in premature infants < 29 weeks of gestational age at high risk for RDS and for the treatment rescue of premature infants < 72 hours of age who develop RDS and require endotracheal intubation.

Drug Dose ::

 Route/Dosage

NEWBORN INFANTS: Intratracheal 3 ml/kg body weight at birth. Dose may be repeated q 12 hr for total of 3 doses.

Contraindication ::

 Contraindications None well documented.

Drug Precautions ::

 Precautions

Administration: Calfactant should be administered intratracheally through an endotracheal tube and only in an acute care unit organized, staffed, equipped and experienced with intubation, ventilation management and general care of newborns with, or at risk for, RDS. Monitoring: Calfactant can rapidly improve oxygenation and lung compliance; monitor patients carefully so that oxygen therapy and ventilatory support can be modified in response to changes in respiratory status. Dosing precautions: If any of the following situations should occur while administering calfactant, interrupt administration and stabilize the infant’s condition before resuming administration: bradycardia; reflux of calfactant into endotracheal tube; airway obstruction; cyanosis; hypoventilation; or dislodgement of endotracheal tube.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Bradycardia. RESP: Cyanosis; airway obstruction. OTHER: Reflux of surfactant into endotracheal tube; requirement for manual ventilation; reintubation.

Drug Mode of Action ::  

 Action Extract of natural surfactant from calf lungs that restores lung surfactant in premature infants with lung surfactant deficiency causing respiratory distress syndrome (RDS).

Drug Interactions ::

 Interactions None well documented.

Drug Assesment ::

 Assessment/Interventions

  • Take baseline vital signs and monitor during and after medication administration.
  • During administration of calfactant liquid suspension into the airway, monitor the infant for bradycardia, reflux of calfactant into the endotracheal tube, airway obstruction, cyanosis, dislodgement of the endotracheal tube, or hypoventilation. If any of these events occur, interrupt administration and stabilize the infant’s condition using appropriate interventions before resuming administration.
  • Monitor lung sounds carefully for any changes (eg, moist rales).
  • Continually monitor oxygen and carbon dioxide levels. If oxygen saturation decreases or bradycardia develops, discontinue administration until the infant is stabilized.
  • Be prepared for possible endotracheal suctioning or re-intubation if signs of airway obstruction are present during administration.
  • Monitor respiratory and oxygen status closely following administration and adjust oxygen therapy and ventilator pressures appropriately.
  • Avoid suctioning patient for one hour after administration unless airway obstruction is present.
  • Assess for signs and symptoms of common complications of prematurity and respiratory distress syndrome (RSD) not necessarily related to calfactant therapy (eg, apnea, patent ductus arteriosus, intracranial hemorrhage, sepsis, pulmonary air leaks, pulmonary interstitial emphysema, pulmonary hemorrhage, necrotizing enterocolitis) and institute appropriate action.
OVERDOSAGE: SIGNS & SYMPTOMS
  Overloading of the lungs with isotonic solution

Drug Storage/Management ::

 Administration/Storage

  • Refrigerate (36° to 46°F) and protect from light.
  • Discard any unused drug after opening.
  • Unopened, unused vials that have been warmed to room temperature can be returned to refrigerator within 24 hrs for future use. Avoid repeated warming.
  • For intratracheal administration only. Administer through an endotracheal tube. Draw dose into a syringe from the single-use vial using a 20–gauge or larger needle; avoid excessive shaking and foaming.
  • Administer only in an acute care setting under clinicians experienced with ventilator management, intubation, and acute and general care of high risk infants in respiratory distress.
  • Do not shake, dilute, or sonicate. If settling has occurred, swirl or roll gently.
  • Calfactant is not to be reconstituted.
  • Visable flecks in the suspension and foaming at the surface are normal and warming before administration is not necessary.
  • Before administration, ensure proper placement and patency of endotracheal tube. If suctioning is required, be sure patient is adequately oxygenated and stabilized before administering.
  • Administer calfactant via the intratracheal route through a side-port adapter into the endotracheal tube. Two qualified medical professionals experienced in the care of high risk infants should facilitate the dosing: One to instill the calfactant and the other to monitor the patient and assist in positioning. After each aliquot is instilled, position the infant on either the right or left side to facilitate distribution.
  • Cafactant also can be administered through a 5 French feeding catheter inserted into the endotracheal tube with the tip above the carina. Do not instill into the main stem bronchus. Attach the catheter to syringe. Fill with medication and discard any excess through catheter to ensure the total dose to be given remains in syringe. Instill the total dose in 4 equal aliquots with the catheter removed between each of the instillations and mechanical ventilation resumed for 30 sec to 2 min. Each of the aliquots should be administered in 1 of 4 different positions (prone, supine, right, and left lateral) to facilitate even distribution of the surfactant. Continue the procedure until the total dose is achieved.
  • Repeat doses can be administered as early as 6 hr after the previous dose for a total of £ 4 doses if the infant is still intubated and required at least 30% inspired oxygen to maintain acceptable PaO2 values.

Drug Notes ::

 Patient/Family Education

  • Provide family with drug information pamphlet.
  • Offer frequent updates to the parents and other family members on the infant’s condition.
  • Encourage whole family participation in the infant’s care whenever possible.
  • Provide emotional support.
  • Make appropriate referrals to hospital services and support groups.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

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