BERACTANT Suspension—25 mg/ml suspended in

Drug class: natural lung surfactant 0.9% sodium chloride injection

Therapeutic actions: A natural bovine compound

containing lipids

and apoproteins that reduce surface tension and allow

expansion of the alveoli; replaces the surfactant Dosages:

missing
Pediatric patients
in the lungs of neonates suffering from RDS.
Accurate determination of birth weight is essential for
Indications:
correct dosage. Beractant is instilled into the trachea
 Prophylactic treatment of infants at risk of
developing using a catheter inserted into the endotracheal tube.

RDS; infants with birth weights less than 1250 g
or infants with birth weights more than 1250 g
have evidence of pulmonary immaturity
 Rescue treatment of infants who have
developed RDS
Contraindications:
 Prophylactic treatment: Give first dose of 100
mg
phospholipids/kg birth weight ( 4 ml/kg) soon
after
birth. Four doses can be administered in the first
48 hours of life. Give no more than every 6 hr.

 Because beractant is used an emergency drug

in  Rescue treatment: Administer 100 mg
phospholipids
acute respiratory situations, the benefits
usually outweigh /kg birth weight (4 ml/kg) intratracheally.
Administer
any possible risks.
the first dose as soon as possible after the
Available forms: diagnosis
 of RDS is made and patient is on the ventilator. pulmonary hemorrhage, apnea,

Repeat doses can be given based on clinical pneumodiastinum, emphysema

improvement
5. Other: Sepsis, non pulmonary infection
And blood gases. Administer subsequent doses
no sooner than every 6 hr. Nursing considerations:

 History: time of birth, exact birth weight

Pharmacokinetics  Physical: skin T, color; R, adventitious sounds,

Route Onset Peak oximeter,
Intratracheal Immediate Hours
endotracheal tube position and patency, chest
movement;
Metabolism: Normal surfactant metabolic pathways;
T ½: Unknown ECG, P.BP, peripheral perfusion and arterial
pressure(desirable);
Distribution: Lung tissue
Oxygen saturation, blood gases, CBC;

muscular activity, facial expressions, reflexes

Adverse Effects
1. CNS: seizures

2. CV: patent ductus arteriosus, intraventricular

hemorrhage,

Hypotension, bradycardia
 Monitor ECG and transcutaneous oxygen
3. Hematologic: hyperbilirubinemia, saturation
thrombocytopenia
continually during administration.
4. Respiratory: pneumothorax, pulmonary air
leak,
 Ensure that endotracheal tube is in the correct
position,
with bilateral chest movement and lung sounds.
 Insert 5 french catheter into the endotracheal
 Have staff view manufacturer’s teaching video
before
 Instill dose quickly; inject one-fourth dose over
regular use to cover all technical aspects of
administration.
 Suction the infant immediately before
administration, but
Do not suction for 1 hour after administration
unless
Clinically necessary.
 Inspect via for discoloration . Vial should contain
off-white
To brown liquid. Gently mix. Warm to room
temperature
Before using – 20 min standing or 8 min warned
by hand.
Don’t use other warning methods.
 Store drug in refrigerator. Protect the light.
Enter drug vial
only once. Discard remaining drug after use.
Unopened ,
unused vials warmed to room temperature may
be returned to refrigerator within 8 hours of
warming.
tube; do not instill into the mainsteam bronchus.
2-3 seconds; remove catheter and reattach
infant to ventilator at least
30 seconds or until stable; repeat procedure
administering
One-fourth dose at a time.
 Do not suction infant for 1 hour after
completion of full dose; do not flush
catheter.
 Continually monitor patient’s color, lung
sounds, ECG, oximeter, and blood gas
readings during administration and for at
least 30 min. afeter.
Teaching points:
 Details of drug effects and
administration are best
incorporated into parent’s
comprehensive teaching
program.