1. Poractant alfa Drugbank ID : DB09113
Half life : Studied in adult and newborn rabbits, the half-life in the lungs was found to be 25 and 67 respectively.
Description :
Poractant alfa is a pulmonary surfactant marketed as Curosurf in the United States and Canada. It is used to treat Respiratory Distress Syndrome (RDS) in premature infants with an endogenous pulmonary surfactant deficiency. Poractant alfa is an extract of natural porcine lung surfactant consisting of 99% polar lipids (mainly phospholipids) and 1% hydrophobic low molecular weight proteins (surfactant associated proteins SP-B and SP-C). The phospholipid content of the extract consists primarily of phosphatidylcholine and dipaImitoylphosphatidylcholine. Poractant alfa is a creamy white suspension of this extract in 0.9% sodium chloride solution. It contains no preservatives.

2. Indication :
Poractant alfa is indicated for the treatment of Respiratory Distress Syndrome (RDS) in premature infants.
Pharmacodynamics :
Poractant alfa improved lung compliance, pulmonary gas exchange and survival in preterm rabbits.
Mechanism of action :
Endogenous pulmonary surfactant reduces surface tension at the air-liquid interface of the alveoli in the lungs, thus stabilizing them against collapse under transpulmonary pressures. A deficiency of pulmonary surfactant in premature infants allows surface tension to increase to the point where sections of lung collapse and respiratory distress syndrome (RDS) develops. Poractant alfa lowers minimum surface tension to less than or equal to 4 mN/m. This compensates for the lack of endogenous surfactant and restores adequate surface activity to the lungs

3. Volume of distribution :
Metabolism :
No studies on the metabolism of poractant alfa have been performed in humans. One small study in rabbits did find that poractant alfa may be degraded by macrophages and that it may, in part, be recycled in the alveoli in a similar manner to endogenous lung surfactant.
Absorption :
Poractant alfa is administered directly to the site of action in the lungs via endotracheal tube. It very rapidly adsorbs to the air-liquid interface to form a stable surfactant monolayer. No studies on absorption of poractant alfa have been performed in humans.
Volume of distribution :
No studies on the distribution of poractant alfa have been performed in humans.
Clearance :
No studies on clearance of poractant alfa have been performed in humans.

4. Toxicity :
Studies on the carcinogenicity or reproductive effects of poractant alfa have not been conducted. Mutagenicity assays were negative. In the case of an overdose with poractant alfa where there are clear clinical effects on the infant's respiration, ventilation, or oxygenation, it is recommended that as much of the solution be aspirated as possible and the infant be managed with supportive measures. Fluid and electrolyte balances should be monitored closely in this case.
Categories : Pulmonary Surfactants
Patents : NA
Brands : Curosurf
Company : Chiesi USA, Inc
Formulation : 80 mg/mL
Form : Suspension
Route of administration : endotracheal

5. Dosage : The initial recommended dose is 2
Dosage : The initial recommended dose is 2.5 mL/kg birth weight, administered as one or two aliquots depending upon the instillation procedure. Contraindication : NA Side effects : Curosurf (poractant alfa) Suspension is a pulmonary surfactant used to treat Respiratory Distress Syndrome (RDS) in premature infants. Curosurf reduces mortality and pneumothoraces (collapsed lung) associated with RDS. Common side effects of Curosurf include slow heart rate, low blood pressure, endotracheal tube blockage, and low blood oxygen levels. Many side effects are associated with premature birth.

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