Name /bks_53161_deglins_md_disk/beractant

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Interactions
Drug-Drug: None known.

beractant (be-rak-tant)

Route/Dosage

Survanta
Classification
Therapeutic: anti-rds agents
Pharmacologic: pulmonary surfactants
Pregnancy Category UK

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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.

NURSING IMPLICATIONS
Assessment

Monitor ECG, heart rate, color, chest expansion, facial expression, transcuta-

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.

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

neous oxygen saturation, and endotracheal tube patency continuously during dosing. Continuous bedside monitoring should continue for at least 30 min after dosing.
If bradycardia and decreased oxygen saturation occur during dosing, stop the
dosing procedure and initiate measures to alleviate the condition. Then resume
dosing.
Lab Test Considerations: Monitor ABGs frequently to prevent hyperoxia or hypocarbia.

Potential Nursing Diagnoses

known.

Impaired gas exchange (Indications)

Distribution: Rapidly distributes to lung tissue.

Metabolism and Excretion: Enters surfactant pathways in which recycling and

Implementation

reutilization occur.
Half-life: Unknown.
TIME/ACTION PROFILE (improved oxygenation)

Inhaln: Does not require reconstitution. Inspect for discoloration before admin-

ment of unstable neonates should perform beractant instillation.

ROUTE

ONSET

PEAK

DURATION

Intratracheal

within min

unknown

unknown

Contraindications/Precautions
Contraindicated in: No known contraindications.
Use Cautiously in: No known cautions. Nosocomial infections may be more common.

Adverse Reactions/Side Effects

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

Genetic Implication.

Only trained medical personnel with experience in airway and clinical manage-

istration. Color should be off-white to light brown. If settling occurs, swirl gently;
do not shake. Beractant must be refrigerated. Warm before administration by allowing to stand at room temperature for 20 min, or warm in the hand for at least 8
min. Do not use artificial warming methods such as a microwave oven. Unopened
vials that have been warmed may be returned to the refrigerator within 24 hrs of
warming. Do not warm and re-refrigerate more than once. Discard unused doses.
Administer intratracheally through a 5 French end-hole catheter inserted into the
infants endotracheal tube with the tip protruding just beyond the end of the endotracheal tube above the infants carina. Shorten the length of the catheter before
insertion to avoid instillation into main-stem bronchus.
Determine dose and withdraw entire contents of vial into a plastic syringe with a
large-gauge (at least 20-gauge) needle. Do not filter or shake. Attach catheter to

CAPITALS indicate life-threatening, underlines indicate most frequent.

Strikethrough Discontinued.

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Evaluation/Desired Outcomes

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end of syringe. Fill catheter with beractant and discard excess through catheter so
that only the total dose remains in the syringe.
Suction the infant endotracheally before instillation of beractant. Check position of
endotracheal tube before instillation. Do not suction for 1 hr after instillation unless clinically necessary.
Rate: To ensure homogeneous distribution, each dose should be divided into
four 1/4 doses. Each 1/4 dose should be administered gently over 2 3 sec with
the infant in different positions. Sequence of positions is head and body inclined
slightly down, head turned to the right; head and body inclined slightly down, head
turned to the left; head and body inclined slightly up, head turned to the right; head
and body inclined slightly up, head turned to the left. Ventilate the infant for at least
30 sec or until stable between each 1/4 dose. After instillation of the last 1/4 dose,
remove the catheter without flushing it.
Prevention Strategy: Administer within 15 min of birth, if possible. Between
each 1/4 dose, manually ventilate with a hand bag with sufficient oxygen to prevent
cyanosis, at a rate of 60 breaths/min, and sufficient positive pressure for adequate
air exchange and chest wall excursion.
Rescue Strategy: Administer as soon as possible after infant is placed on the ventilator for management of RDS (preferably by 8 hr of age). Immediately before instillation of first 1/4 dose and between each 1/4 dose, ventilate with ventilator settings at 60/min, inspiratory time 0.5 sec, and FIO2.
Repeat Doses: Can be given no sooner than 6 hr after preceding dose. Obtain radiologic confirmation of RDS before repeat dose in those who received drug for
prevention. FIO2 may be increased by 0.2 or amount sufficient to prevent cyanosis.
Ventilator rate may be set at 30/min with an inspiratory time of 1 sec. If pretreatment rate was 30/min, it may be unchanged during repeat dose. Do not use manual hand bag ventilation during repeat doses. Repeat doses should be based on
birth weight.

Prevention of RDS.
Improvement in lung compliance.
Improved oxygenation.
Normalization of ABGs.

Why was this drug prescribed for your patient?

Patient/Family Teaching
Explain purpose of medication to parents.
2015 F.A. Davis Company

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