calfactant

Action and Spectrum

Mechanism of action

Pulmonary surfactant is a critical component of the normal functioning of the lungs, and its deficiency can lead to respiratory distress syndrome (RDS) in premature infants. RDS occurs when the surface tension at the air-fluid interface of the alveoli becomes too high, causing portions of the lung to collapse and making it difficult for the infant to breathe.

In cases of surfactant deficiency, it can be used as a replacement therapy. calfactant is a synthetic surfactant designed to mimic the properties of natural lung surfactant and help decrease the surface tension at the air-fluid interface. It adsorbs quickly to the alveolar surface and modifies surface tension to a minimum of fewer than 3mN/m, thereby preventing or treating RDS

Spectrum

The spectrum of activity of calfactant includes its ability to reduce surface tension, improve lung compliance, promote oxygenation, and reduce inflammation and oxidative stress in the lungs. These properties make calfactant a vital treatment option for premature infants with RDS

Drug Interaction

Adverse Reaction

Frequency defined:

>10%

airway obstruction (39%)

requirement of manual ventilation (16%)

cyanosis (65%)

bradycardia (34%)

reflux into ETT (21%)

1-10%

reintubation (3%)

Black Box Warning

Contraindication / Caution

Contraindications

None

Caution

• Prematurity: calfactant is only approved for use in premature infants with RDS and is not recommended for full-term infants or adults
• Dosage: calfactant should only be administered by a healthcare professional trained in its use, and the correct dosage should be carefully followed to minimize the risk of adverse effects
• Monitoring: Infants receiving calfactant should be carefully monitored for signs of adverse effects, including changes in heart rate, breathing patterns, and oxygen saturation levels
• Allergic reactions: Although rare, allergic reactions to calfactant can occur. Infants should be carefully monitored for signs of an allergic reaction, including hives, swelling, and difficulty breathing
• Drug interactions: calfactant may interact with other medications being taken by the infant, so it is essential to discuss all medications with a healthcare professional before starting treatment with calfactant

Pregnancy / Lactation

Pregnancy consideration: Not applicable

Lactation: Not applicable

Pregnancy category:

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology

It is composed of phospholipids, neutral lipids, and surfactant-associated proteins. The phospholipids and neutral lipids in calfactant are responsible for reducing surface tension at the air-fluid interface in the alveoli, thereby preventing lung collapse and improving lung compliance. The surfactant-associated proteins in calfactant have anti-inflammatory properties, which help to reduce inflammation and oxidative stress in the lungs

Pharmacodynamics

calfactant is a synthetic surfactant composed of phospholipids, neutral lipids, and surfactant-associated proteins. The phospholipids and neutral lipids in calfactant work to reduce surface tension at the air-fluid interface in the alveoli, preventing lung collapse and improving lung compliance. The surfactant-associated proteins in calfactant have anti-inflammatory properties and help to reduce inflammation and oxidative stress in the lungs

Pharmacokinetics

Absorption

calfactant is administered intratracheally into the lungs, and rapidly adsorbs to the air-fluid interface in the alveoli. Because calfactant is not absorbed systemically, it has a localized effect on the lungs and does not produce systemic side effects

Distribution

calfactant does not distribute systemically, as it is rapidly metabolized and cleared from the body

Metabolism

calfactant is rapidly metabolized and cleared from the body, with a half-life of fewer than 30 minutes. This rapid clearance means repeated doses of calfactant may be necessary to maintain its therapeutic effects

Elimination/Excretion

calfactant is excreted primarily through the lungs, as it is not absorbed systemically. Some phospholipids and neutral lipids in calfactant may be excreted through the kidneys and bile, but these amounts are generally small

Adminstartion

Administration

The medication should be divided into 2 or 4 equal aliquots, and the infant should be positioned on their side after each instillation. The administration should occur while ventilation is continued for 20-30 breaths for each aliquot. The vial should be stored in a refrigerator and may be swirled to redistribute the medication. Warming the medication is not necessary

Patient Information Leaflet

Patient information leaflet

Generic Name: calfactan

Pronounced: [ kal-FAK-tant ]

Why do we use calfactan?

calfactant is a synthetic surfactant used to treat respiratory distress syndrome (RDS) in premature infants