lucinactant

Action and Spectrum

Actions and Spectrum 

Action:  

lucinactant functions as a pulmonary surfactant, playing a crucial role in the lungs. Surfactant is a substance that reduces surface tension, enabling the alveoli (tiny air sacs) in the lungs to expand and operate effectively. 

In infants with RDS, the production of natural surfactant is inadequate, resulting in collapsed alveoli and difficulty in breathing. lucinactant provides exogenous surfactant, restoring the lung’s ability to expand and decreasing the work of breathing. 

Spectrum:  

lucinactant has a broad spectrum of action in the treatment of respiratory distress syndrome. The medication is specifically prescribed to treat respiratory distress syndrome (RDS) in preterm infants, specifically those born prior to 34 weeks of gestation.

RDS is a prevalent condition among premature babies, marked by inadequate surfactant production resulting in respiratory failure.The drug helps improve lung function, reduces the risk of complications associated with RDS, and improves the overall prognosis for premature infants with this condition. 

Drug Interaction

Adverse Reaction

Frequency defined  

>10% 

ETT reflux (18%) 

1-10% 

ETT obstruction (6%) 

Pallor (9%) 

Dose interruption (9%) 

Black Box Warning

Black Box Warning:  

None  

Contraindication / Caution

Contraindication/Caution:  

Hypersensitivity: The drug should not be used in individuals who have a known hypersensitivity. 

Bacterial or fungal infections: The drug is not recommended for use in infants with active bacterial or fungal infections, as it may worsen the condition or increase the risk of systemic infection. 

Intracranial hemorrhage or severe   

bleeding: The drug should be used with caution in infants with a history of significant bleeding, such as intracranial hemorrhage, due to the risk of exacerbating bleeding.  

Coagulation disorders: Infants with known coagulation disorders, such as hemophilia or thrombocytopenia, may require careful monitoring and consideration of the risks and benefits before using lucinactant. 

Neonates at risk of pneumothorax: The drug administration may increase the risk of pneumothorax (collapsed lung) in infants who are already at an increased risk due to certain underlying conditions or interventions. 

Respiratory conditions other than RDS: The drug is specifically indicated for the treatment of RDS and should not be used in infants with other respiratory conditions without proper evaluation and guidance from a healthcare professional. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

<b>Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.   

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 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:  

The drug is a synthetic peptide-based pulmonary surfactant used in neonatal medicine to treat respiratory distress syndrome (RDS) in premature infants. The drug is designed to mimic the function of natural pulmonary surfactant, which is produced by the lungs to reduce surface tension and maintain the stability of the alveoli. 

Pharmacodynamics:  

lucinactant contains phospholipids, primarily dipalmitoylphosphatidylcholine (DPPC), which is a major component of natural surfactant. When administered intratracheally, lucinactant spreads across the alveolar surface, reducing surface tension and increasing lung compliance. This action prevents the collapse of alveoli, allowing for efficient gas exchange. 

Effects on the Respiratory System: 

Reduces Surface Tension: The primary pharmacodynamic effect of lucinactant is its ability to lower surface tension within the alveoli. By reducing surface tension, it helps to maintain the patency of the alveoli during expiration, preventing alveolar collapse and improving gas exchange. 

Improves Lung Compliance: lucinactant improves lung compliance by reducing the work of breathing. It reduces the pressure required to open collapsed alveoli, allowing the lungs to expand more easily during inspiration.   

Pharmacokinetics: 

Absorption 

The drug is administered via intratracheal instillation, directly into the lungs of premature infants. This route of administration allows for direct absorption of the drug into the lung tissue. 

Distribution 

The drug is expected to distribute within the lungs to reach the alveoli, where it can exert its therapeutic effects. The surfactant helps reduce surface tension in the alveoli, preventing their collapse during expiration and improving lung function. 

Metabolism 

Surfactants like lucinactant are generally not metabolized in the body, as they are synthetic compounds designed to mimic the natural surfactant found in healthy lungs. Therefore, the metabolism of lucinactant is not a significant factor.  

Excretion and elimination 

The drug is typically cleared from the lungs through various clearance mechanisms, such as mucociliary clearance and lymphatic drainage. It is gradually eliminated from the body over time, and any remnants are cleared via normal lung function. 

Adminstartion

Administration:  

Once the endotracheal tube is in place, the drug is slowly instilled into the tube.  

The recommended dose and rate of administration will depend on the specific brand and formulation of lucinactant being used, as well as the infant’s weight and clinical condition.  

The healthcare provider will follow the instructions provided by the manufacturer or local protocols. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: lucinactant 

Why do we use lucinactant?  

Treatment of RDS: It helps to improve lung function by reducing surface tension and preventing collapse of the alveoli (tiny air sacs in the lungs). By improving lung compliance, lucinactant enhances oxygen exchange and reduces the need for mechanical ventilation. 

Reducing the risk of complications: By administering this drug to premature infants with RDS, healthcare providers aim to minimize the risk of complications associated with the condition. These complications can include chronic lung disease, pneumonia, and other respiratory infections. 

Enhancing oxygenation: It promotes improved oxygenation of the blood, a vital factor for the overall welfare of premature infants experiencing respiratory distress. 

Supporting respiratory function: The drug acts as a replacement for the natural lung surfactant that is deficient in infants with RDS. By restoring the surfactant levels, it reduces the effort required for breathing and helps the lungs expand more easily, thus supporting respiratory function. 

Potential future applications: Ongoing research is being conducted to investigate the potential application of this medication in various respiratory conditions, including adult acute respiratory distress syndrome (ARDS). 

ARDS is a severe lung injury that can occur in response to various causes, including infections, trauma, or severe inflammation.