Search your Drugs Here

Monday, February 7, 2011

montelukast sodium

Posted by Sampil 5:58 PM, under | No comments

montelukast sodium
(mon tell oo' kast)
Singulair

Pregnancy Category B

Drug classes
Antasthmatic
Leukotriene receptor antagonist

Therapeutic actions
Selectively and competitively blocks the receptor that inhibits leukotriene formation, thus blocking many of the signs and symptoms of asthma—neutrophil andeosinophil migration, neutrophil and monocyte aggregation, leukocyte adhesion, increased capillary permeability, and smooth muscle contraction. These actions contribute to inflammation, edema, mucus secretion, and bronchoconstriction associated with the signs and symptoms of asthma.

Indications
·        Prophylaxis and chronic treatment of asthma in adults and children > 12 mo
·        Relief of symptoms of seasonal allergic rhinitis in adults and children > 2 yr
·        Relief of symptoms of perennial allergic rhinitis in adults and children > 6 mo
·        Unlabeled uses: Chronic urticaria, atopic dermatitis

Contraindications and cautions
·        Contraindicated with hypersensitivity to montelukast or any of its components; acute asthma attacks; status asthmaticus.
·        Use cautiously with pregnancy and lactation.

Available forms
Tablets—10 mg; chewable tablets—4, 5 mg; granules—4 mg/packet

Dosages
ADULTS AND PATIENTS > 15 YR
One 10 mg tablet PO daily, taken in the evening.
PEDIATRIC PATIENTS
6 mo–23 mo (perennial allergic rhinitis): 1 packet (4 mg) PO per day.
12–23 mo (asthma only): 4 mg granules PO daily, taken in the evening.
2–5 yr: One 4-mg chewable tablet PO daily, taken in the evening.
6–14 yr: One 5-mg chewable tablet PO daily, taken in the evening.

Pharmacokinetics
Route
Onset
Peak
Oral
Rapid
2–4 hr

Metabolism: Hepatic; T1/2: 2.7–5.5 hr
Distribution: Crosses placenta and enters breast milk
Excretion: Feces, urine

Adverse effects
·        CNS: Headache, dizziness
·        GI: Nausea, diarrhea, abdominal pain, dental pain
·        Respiratory: Influenza, cold, nasal congestion
·        Other: Generalized pain, fever, rash, fatigue

Interactions
·        Decreased effects and bioavailability if taken with phenobarbitalrifampin; monitor patient and adjust dosage as needed

Nursing considerations
Assessment
·        History: Hypersensitivity to montelukast or any of its components; acute asthma attacks; status asthmaticus, pregnancy and lactation
·        Physical: T; orientation, reflexes; R, adventitious sounds; GI evaluation

Interventions
·        Administer in the evening without regard to food.
·        Ensure that drug is taken continually for optimal effect.
·        Do not administer for acute asthma attack or acute bronchospasm.
·        Avoid the use of aspirin or NSAIDs in patients with known sensitivities while they are using this drug.
·        WARNING: Ensure that patient has a readily available rescue medication for acute asthma attacks or situations when a short-acting inhaled agent is needed.

Teaching points
·        Take this drug regularly as prescribed; do not stop taking this drug during symptom-free periods; do not stop taking this drug without consulting your health care provider. Continue taking any other drugs for treating asthma that have been prescribed for you. Notify your health care provider if your asthma becomes worse.
·        Do not take this drug for an acute asthma attack or acute bronchospasm; this drug is not a bronchodilator, and routine emergency procedures should be followed during acute attacks.
·        Avoid the use of aspirin or NSAIDs if you have a known sensitivity to these drugs. Montelukast will not prevent reactions.
·        You may experience these side effects: Dizziness (use caution when driving or performing activities that require alertness); nausea, vomiting (eat frequent small meals, take drug with food); headache (analgesics may be available).
·        Report fever, acute asthma attacks, flulike symptoms, lethargy.

Adverse effects in Italic are most common; those in Bold are life-threatening.

0 comments:

Post a Comment

Tags

Blog Archive

Blog Archive