Dosing and uses of Curosurf (poractant alfa)
Adult dosage forms and strengths
Not indicated
Pediatric dosage forms and strengths
intratracheal suspension
- 8mg/mL (1.5mL, 3mL)
Respiratory Distress Syndrome
Prevention: 1.25-2.5 mL/kg once within 15 min of birth; administer additional doses only in infants who continue to require mechanical ventilation and supplemental oxygen
Treatment: 2.5 mL/kg birth weight intratracheal, THEN 1.25 mL/kg q12hr two times PRN (not to exceed 5 mL/kg total); administer additional doses only in infants who continue to require mechanical ventilation and supplemental oxygen
Administration
Instill thru 5 French endhole catheter inserted into (but not beyond distal tip of) ETt
Ensure proper placeent and patancy of the endotracheal tube before administering
May suction endotracheal tube before administering poractant alpha
Each dose instilled as 2 half-doses, with body in different positions to assure adequate distribution
Store vials in fridge, slowly warm to room temp (no artificial warming); invert to mix (no shaking!), discard vial after single use
Curosurf (poractant alfa) adverse (side) effects
Frequency not defined
Transient bradycardia
Hypotension
Oxygen desaturation
ETT blockage
Reflux
Airway obstruction
Hypoxia
Pulmonary hemorrhage
Warnings
Contraindications
None listed by the manufacturer
Cautions
Pulmonary hemorrhage may occur in premature birth and very low birth-weight
Rales, moist breathing sounds may occur normally with administration
Infant may exhibit bradycardia, reflux, cyanosis, airway obstruction
Use for intratracheal administration only
Correct hypotension, hypothermia, hypoglycemia, acidosis, and anemia before use
Pregnancy and lactation
Pregnancy category: Not applicable
Lactation: Not applicable
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Curosurf (poractant alfa)
Mechanism of action
Replaces deficient endogenous lung surfactant in neonates with respiratory distress syndrome
Surfactant prevents the alveoli from collapsing during expiration by lowering surface tension between alveolar surfaces and air
