colfosceril palmitate (Exosurf Neonatal)

Introduction

Tradename: Exosurf Neonatal.

Indications

• prophylaxis for neonatal respiratory distress syndrome (RDS)
  • infants with birth weight < 1350 g
  • infants with birth weight > 1350 g & evidence of pulmonary insufficiency
• rescue therapy for neonatal RDS
  • not attributable to other causes
  • radiographic findings consistent with RDS

Dosage

• doses administered as 2 2.5 mL/kg 1/2 dose
• special endotracheal tube adaptors are required
• 5 mL/kg as soon as possible after birth or diagnosis
• 2nd & 3rd doses 12 & 24 hours later for infants remaining on respirator
• apply suction prior to administration, but not for 2 hours following administration
• administer into trachea by experienced neonatologist

Reconstituted suspension should be used immediately, with the unused portion discarded.

Different size endotracheal tube adaptors are supplied

Suspension for endotracheal administration: 108 mg (10 mL).

Pharmacokinetics

elimination: lung

Adverse effects

• not common (1-10%)
  • pulmonary hemorrhage, apnea, mucous plugging, diminished transcutaneous paO2 of > 20%

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3032281