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Մասնակից:Գայանե Մանասյան/Ավազարկղ

Կաղապար:Infobox drug

Pulmonary surfactant is used as a medication to treat and prevent respiratory distress syndrome in newborn babies.[1] Prevention is generally done in babies born less than 32 weeks gestational age.[1] It is given by the endotracheal tube.[1] Onset of effects is rapid.[2] A number of doses may be needed.[2]

Side effects may include slow heart rate and low oxygen levels.[1] Its use is also linked with intracranial bleeding.[1] Pulmonary surfactant may be isolated from the lungs of cows or pigs or made artificially.[1][3][4]

Pulmonary surfactant was discovered in the 1950s and a manufactured version was approved for medical use in the United States in 1990.[3] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[5] In the United Kingdom it costs the NHS 281.64 to 547.40 pounds per dose.[1]

Medical uses

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Pulmonary surfactant is used to treat and prevent respiratory distress syndrome in newborn babies.[1] Prevention is generally done in babies born less than 32 weeks gestational age.[1] Tentative evidence supports use in drowning.[6]

Types

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Տե՛ս նաև՝ Pulmonary surfactant § composition

There are a number of types of pulmonary surfactants available. Like their natural counterparts, pulmonary surfactant preparations consist of phospholipids (mainly DPPC) combined with spreading agents such as SP-B and SP-C.[7]

Synthetic pulmonary surfactants:

  • Colfosceril palmitate (Exosurf) - a mixture of DPPC with hexadecanol and tyloxapol added as spreading agents
  • Pumactant (Artificial Lung Expanding Compound or ALEC) - a mixture of DPPC and PG
  • Lucinactant (KL-4) - composed of DPPC, palmitoyl-oleoyl phosphatidylglycerol, and palmitic acid, combined with a 21 amino acid synthetic peptide (sinapultide) that mimics the C-terminal helical domain of SP-B.[8]
  • Venticute - DPPC, PG, palmitic acid and recombinant SP-C
  • Lucinactant (trade name Surfaxin) is a liquid medication that contains DPPC, POPG as the sodium salt, and palmitic acid.

Animal derived surfactants:

  • Beractant
    • (Alveofact) - extracted from cow lung lavage fluid, manufacturing by Boehringer Ingelheim
    • (Survanta) - extracted from minced cow lung with additional DPPC, palmitic acid and tripalmitin, manufacturing by Abbvie
    • (Beraksurf) - extracted from minced cow lung with additional DPPC, palmitic acid and tripalmitin, manufacturing by Tekzima
  • Calfactant (Infasurf) - extracted from calf lung lavage fluid
  • Poractant alfa (Curosurf) - extracted from material derived from minced pig lung

History

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Researcher John Clements identified surfactants and their role in the 1950s. Mary Ellen Avery soon after showed that the lungs of premature infants couldn't produce surfactants.[9]

Exosurf, Curosurf, Infasurf, and Survanta were the initial surfactants FDA approved for use in the U.S.[10]

In 2012 the US FDA approved an additional synthetic surfactant, lucinactant (Surfaxin).

References

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  1. ↑ 1,0 1,1 1,2 1,3 1,4 1,5 1,6 1,7 1,8 British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. էջ 217. ISBN 9780857111562.
  2. ↑ 2,0 2,1 Fanaroff, Avroy A.; Fanaroff, Jonathan M. (2013). Klaus and Fanaroff's Care of the High-Risk Neonate, Expert Consult - Online and Print,6: Klaus and Fanaroff's Care of the High-Risk Neonate (անգլերեն). Elsevier Health Sciences. էջ 252. ISBN 1416040013. Արխիվացված օրիգինալից 2017-01-09-ին.
  3. ↑ 3,0 3,1 Lantos, John D.; Meadow, William L. (2006). Neonatal Bioethics: The Moral Challenges of Medical Innovation (անգլերեն). JHU Press. էջեր 54–56. ISBN 9780801883446. Արխիվացված օրիգինալից 2017-01-09-ին.
  4. ↑ Slonim, Anthony D.; Pollack, Murray M. (2006). Pediatric Critical Care Medicine (անգլերեն). Lippincott Williams & Wilkins. էջեր 724–725. ISBN 9780781794695. Արխիվացված օրիգինալից 2017-01-09-ին.
  5. ↑ «WHO Model List of Essential Medicines (19th List)» (PDF). World Health Organization. April 2015. Արխիվացված (PDF) օրիգինալից 13 December 2016-ին. Վերցված է 8 December 2016-ին.
  6. ↑ Brady, Bill; Charlton, Nathan P.; Lawner, Benjamin J.; Sutherland, Sara F. (2012). Cardiac Arrest, An Issue of Emergency Medicine Clinics (անգլերեն). Elsevier Health Sciences. էջ 175. ISBN 1455742767. Արխիվացված օրիգինալից 2017-01-09-ին.
  7. ↑ Nkadi, Paul O.; Merritt, T. Allen; Pillers, De-Ann M. (2009). «An overview of pulmonary surfactant in the neonate: Genetics, metabolism, and the role of surfactant in health and disease». Molecular Genetics and Metabolism. 97 (2): 95–101. doi:10.1016/j.ymgme.2009.01.015. ISSN 1096-7192. PMC 2880575.
  8. ↑ «KL4 Surfactant Technology - Windtree Therapeutics, Inc». Windtree Therapeutics, Inc. Արխիվացված է օրիգինալից July 29, 2018-ին. Վերցված է 29 November 2017-ին.
  9. ↑ Palca, Joe (3 August 2015). «How A Scientist's Slick Discovery Helped Save Preemies' Lives». NPR. Արխիվացված օրիգինալից 3 August 2015-ին. Վերցված է 3 August 2015-ին.
  10. ↑ Taeusch, H William; Lu, Karen; Ramierez-Schrempp, Daniela (2002). «Improving pulmonary surfactants» (PDF). Acta Pharmacologica Sinica. 23 Suppl: 11–5. Արխիվացված (PDF) օրիգինալից 2015-03-01-ին.

Կատեգորիա:World Health Organization essential medicines Կատեգորիա:RTT

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