Nursing Implications for ZAFIRLUKAST Accolate

ZAFIRLUKAST

(za-fir-lu′kast) 

Accolate 

Classifications: RESPIRATORY SMOOTH MUSCLE RELAXANT; LEUKOTRIENE RECEPTOR ANTAGONIST (LTRA); BRONCHODILATOR 

Therapeutic: BRONCHODILATOR; LTRA 

Pregnancy Category: B 

AVAILABILITY 

Tablet 

ACTION & THERAPEUTIC EFFECT 

Selective leukotriene receptor antagonist (LTRA) that inhibits binding of leukotriene D4 and E4, thus inhibiting inflammation and bronchoconstriction. Leukotriene production and receptor affinity have been correlated with the pathogenesis of asthma. Zafirlukast helps to prevent the signs and symptoms of asthma, including airway edema, smooth muscle constriction, and altered cellular activity due to inflammation. 

USES 

Prophylaxis and chronic treatment of asthma in adults and children older than 5 y (not for acute bronchospasm). 

CONTRAINDICATIONS 

Hypersensitivity to zafirlukast; acute asthma attacks, including status asthmaticus, acute bronchospasm; lactation. 

CAUTIOUS USE 

Hepatic impairment, hepatic disease; corticosteroid withdrawal or reduction in dose; patients 65 y or older, pregnancy (category B); children younger than 5 y. 

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NURSING IMPLICATIONS ZAFIRLUKAST Accolate

ROUTE & DOSAGE 

Asthma 

Adult: PO 20 mg b.i.d. 1 h before or 2 h after meals Child (5 y or older): PO 10 mg b.i.d. 

ADMINISTRATION 

Oral 

• Give 1 h before or 2 h after meals. 
• Store at 20°–25° C (68°–77° F); protect from light and moisture. 

ADVERSE EFFECTS (≥1%) 

Body as a Whole: Generalized pain, asthenia, myalgia, fever, back pain. CNS: Headache, dizziness. GI: Nausea, diarrhea, abdominal pain, vomiting, dyspepsia; liver dysfunction, increased liver function tests, hepatic failure. Other: Churg-Strauss syndrome (fever, muscle aches and pains, weight loss). 

INTERACTIONS 

Drug: May increase prothrombin time (PT) in patients on warfarin. Erythromycin decreases bioavailability of zafirlukast. 

PHARMACOKINETICS 

Absorption: Rapidly from GI tract, bioavailability significantly reduced by food. Onset: 1 wk. Peak: 3 h. Distribution: Greater than 99% protein bound; secreted into breast milk. Metabolism: In liver (CYP2C9). Elimination: 90% in feces, 10% in urine. Half-Life: 10 h. 

NURSING IMPLICATIONS 

Assessment & Drug Effects 

• Assess respiratory status and airway function regularly. 
• Monitor closely phenytoin level with concurrent phenytoin therapy.
• Montior lab tests: Periodic LFTs, PT, and INR with concurrent warfarin therapy. 

Patient & Family Education 

• Taking medication regularly, even during symptom-free periods.
• Note: Drug is not intended to treat acute episodes of asthma. 
• Report S&S of hepatic toxicity (see Appendix F) or flu-like symptoms to prescriber. Followup lab work is very important. 
• Notify prescriber immediately if condition worsens while using prescribed doses of all antiasthmatic medications.

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Ditulis oleh Unknown pada tanggal Friday, July 3, 2015