Kurosurf
Kurosurf: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Use in childhood
- 10. Drug interactions
- 11. Analogs
- 12. Terms and conditions of storage
- 13. Terms of dispensing from pharmacies
- 14. Reviews
- 15. Price in pharmacies
Latin name: Curosurf
ATX code: R07AA
Active ingredient: Poractant alfa
Manufacturer: Chiesi Pharmaceuticals, S.p. A. (Chiesi Farmaceutici, SpA) (Italy)
Description and photo update: 2019-24-07
Prices in pharmacies: from 22500 rubles.
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Kurosurf - a drug for the prevention and treatment of respiratory distress syndrome in newborns, surfactant.
Release form and composition
Kurosurf is available in the form of a suspension for endotracheal administration: from yellowish to white (1.5 or 3 ml each in glass vials without color, 1 or 2 vials in a polystyrene case, 1 case in a cardboard box) and instructions for use of Kurosurf.
1 ml of suspension contains:
- active substance: practant alpha - 80 mg, which is equivalent to about 74 mg of the total amount of phospholipids;
- excipients: sodium chloride, water for injection.
In 1 bottle, the content of the active substance is:
- a bottle of 1.5 ml - 120 mg;
- bottle of 3 ml - 240 mg.
Pharmacological properties
Pharmacodynamics
Kurosurf is a drug for the prevention and treatment of respiratory distress syndrome (RDS) in newborns. Its active ingredient, alpha practant, is a surfactant of animal origin isolated from pig lungs. The surfactant contains exclusively polar lipids, of which phosphatidylcholine is about 70% of the total amount of phospholipids and specific hydrophobic low molecular weight proteins SP-B and SP-C are about 1%.
The action of Kurosurf is aimed at replenishing the deficiency and stimulating the production of endogenous pulmonary surfactant in the functionally immature lungs of premature infants. When administered intratracheally, alpha practant is evenly distributed in the lungs, spreading on the surface of the alveoli, contributing to the maintenance of adequate gas exchange during the entire respiratory cycle. By covering the inner surface of the alveoli, it stabilizes them and lowers the surface tension in the lungs, preventing alveoli from sticking together at the end of the expiratory phase. Restores the level of oxygenation in premature infants, which causes the need to lower the oxygen concentration in the inhaled gas mixture. The use of a surfactant significantly reduces the severity of RDS,reduces the level of complications and mortality in premature infants from respiratory diseases.
Pharmacokinetics
The half-life is 67 hours.
48 hours after administration, surfactant lipids are found in the blood serum and other organs only in trace amounts.
Indications for use
The use of Kurosurf is indicated for the treatment and prevention of RDS in premature infants weighing more than 700 g.
Contraindications
The use of Kurosurf in infants with hypersensitivity to the components of the drug is contraindicated.
Kurosurf, instructions for use: method and dosage
The suspension is intended for endotracheal administration.
The use of Kurosurf is indicated only in intubated children in a hospital setting who are on mechanical ventilation (artificial lung ventilation) with constant monitoring of heart rate (heart rate) and the level of oxygen concentration in the arterial bed (blood oxygen saturation).
The appointment of Kurosurf is made by a doctor with experience in resuscitation and treatment of premature babies.
Treatment should be started immediately after the diagnosis of RDS.
The procedure is performed under strict sterility conditions. Before use, the contents of the vial must be heated to 37 ° C. Avoiding shaking, carefully turning the bottle upside down, take the suspension into the syringe. Then, through the endotracheal tube, the drug is injected into the lower trachea. For even distribution of the suspension in the lungs immediately after administration, manual ventilation must be carried out for 1–2 minutes. The inhaled oxygen concentration should be equal to the reference reading on the ventilator.
The end of the catheter used to introduce the Kurosurf should be 0.5 cm shorter than the lower end of the endotracheal tube.
Recommended dosage:
- emergency therapy: initial dose - at the rate of 100-200 mg (1.25-2.5 ml) per 1 kg of the child's body weight (mg / kg), once. If clinically necessary, additional administration of the drug at a dose of 100 mg / kg with an interval of 12 hours is allowed;
- prevention: the first dose (during the first 1/4 hour after the birth of a child with suspicion of the possible development of RDS) - 100-200 mg / kg, after 6-12 hours a second dose is administered at a rate of 100 mg / kg. If the diagnosis of RDS is confirmed, then the drug at a dose of 100 mg / kg is continued at intervals of 12 hours.
The total maximum dose is 400 mg / kg.
Side effects
Against the background of the use of Kurosurf, the development of such undesirable effects as allergic reactions, pulmonary bleeding is possible. In rare cases, a child may experience arterial hypotension, bradycardia, a decrease in the level of oxygen concentration in the arterial bed, a temporary (from 2 to 10 minutes) decrease in the electrical activity of the brain.
In addition, blockage of the endotracheal tube due to mucus accumulation should be considered.
Overdose
Overdose symptoms have not been established.
Treatment: in case of an overdose, accompanied by clear clinical manifestations of ventilation, respiration or oxygenation, it is necessary to aspirate the suspended contents from the lungs as much as possible. The appointment of measures aimed at maintaining the water and electrolyte balance is recommended.
special instructions
The use of Kurosurf should be started after preliminary correction of arterial hypotension, acidosis, anemia, hypothermia and hypoglycemia.
In case of reflux, the drug should be suspended. The level of peak inspiratory pressure on the ventilator must ensure sufficient clearance of the endotracheal tube.
The presence of pulmonary secretion in a child before the administration of the drug increases the likelihood of blockage of the endotracheal tube as a result of the accumulation of mucus, which can lead to a noticeable deterioration in ventilation during the administration of Kurosurf or immediately after it. Therefore, to reduce the risk of endotracheal tube obstruction, mucus should be aspirated before drug administration. If the obstruction cannot be removed, immediate replacement of the endotracheal tube is required.
Aspiration of tracheobronchial secretions is not recommended for the first 6 hours after drug administration, except in cases that pose a threat to life.
If the child has bradycardia, arterial hypotension and a decrease in blood oxygen saturation, then drug treatment is temporarily suspended and resumed after the heart rate is normalized.
With hypoplasia of the lungs, caused by a long intrauterine anhydrous period (more than 3 weeks), children may react poorly to the therapy with natural surfactant.
Therapy with Kurosurf cannot completely eliminate mortality and morbidity in preterm infants, since preterm birth may be accompanied by other complications in children due to their immaturity.
For the purpose of prophylaxis, the drug is recommended for use in premature infants with a gestational age of 24 to 25 weeks. If the gestational age of preterm infants is between 26 and 28 weeks, then prevention of RDS is indicated only in the absence of antenatal use of corticosteroids.
Prevention of RDS in premature infants with gestational age up to 28 weeks is recommended in the presence of such risk factors for the development of RDS as perinatal asphyxia, caesarean section, the presence of diabetes mellitus in the mother, the need for intubation at birth, the male sex of the child, an indication of a predisposition to RDS in the family anamnesis.
In premature infants with a gestational age of 29 weeks or more, the use of the drug is indicated only with the development of RDS.
Treatment with the drug must be accompanied by continuous monitoring of arterial blood gas and tissue oxygen content. It should be borne in mind that against the background of the restoration of gas exchange in the alveoli, a rapid increase in the oxygen concentration in the arterial bed can occur. To avoid hyperoxia in this case, an immediate readjustment of the ventilation parameters is required.
Pediatric use
Curosurf is used intratracheally in intubated infants with mechanical ventilation.
Drug interactions
The interaction of practant alpha with other drugs has not been established.
Analogs
The analogs of Kurosurf are: Alveofact, Surfactant HL, Surfactant BL, Survant, Exosurf for newborns.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures from 2 to 8 ° C, protected from light.
The shelf life is 1.5 years.
Terms of dispensing from pharmacies
Released for hospitals.
Reviews about Kurosurf
Reviews about Kurosurf are positive. Parents point to the high efficacy of the drug in relieving respiratory distress syndrome in premature newborns. In severely premature infants with critical body weight, the use of the drug is necessary and increases the chance of survival. Several timely injections of surfactant effectively restore lung mechanics and can avoid or significantly shorten the period of use of mechanical ventilation.
Price for Kurosurf in pharmacies
The price for Kurosurf for a package containing 1 bottle (1.5 ml) of suspension can range from 10,500 to 22,280 rubles.
Kurosurf: prices in online pharmacies
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Drug name Price Pharmacy |
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Kurosurf 80 mg / ml suspension for endotracheal administration in newborns sterile 1.5 ml 1 pc. RUB 22,500 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
