Aztreonam inhalation

Indications

Aztreonam inhalation is used for: Cystic Fibrosis (CF)

Adult Dose

Cystic Fibrosis (CF) Indicated to improve respiratory symptoms in patients with CF infected with Pseudomonas aeruginosa 75 mg inhaled q8hr for 28 days; use only with Alterna nebulizer; do not repeat for 28 days after completion Doses should be administered at least 4 h apart Use bronchodilator before administration; administer short-acting beta agonists 15 min to 4 h before or long-acting beta agonists 30 min to 12 h before If taking mucolytics, take after bronchodilators, but before aztreonam

Child Dose

Cystic Fibrosis (CF) Indicated to improve respiratory symptoms in patients with CF infected with Pseudomonas aeruginosa <7 years: Safety/efficacy not established >7 years: As adults, 75 mg inhaled q8hr for 28 days; use only with Alterna nebulizer; do not repeat for 28 days after completion Doses should be administered at least 4 h apart

Renal Dose

Administration

Contra Indications

Hypersensitivity

Precautions

Allergic reactions observed in clinical trials, stop treatment if allergic reaction occurs May cause bronchospasm, stop treatment if chest tightness develops during nebulizer use Increases FEV1 during 28-day course, consider baseline FEV1 when evaluating whether post-treatment changes in FEV1 are caused by pulmonary exacerbation Increased risk of drug-resistant bacteria in absence of known Pseudomonas aeruginosa

Pregnancy-Lactation

Pregnancy Available data on use in pregnant women is insufficient to inform a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; however, systemic absorption of aztreonam following inhaled administration is expected to be minimal There are risks to the mother associated with cystic fibrosis in pregnancy; cystic fibrosis may increase the risk for preterm delivery Animal data In animal reproduction studies with aztreonam for injection administered parenterally to pregnant rats and rabbits during organogenesis, there was no evidence of developmental toxicity; a peri/postnatal study in rats revealed no drug-induced changes in maternal, fetal, or neonatal parameters Lactation Following intravenous administration, drug is excreted in human milk at concentrations that are less than one percent of those determined in simultaneously obtained maternal serum Peak plasma concentrations of aztreonam following administration of 75 mg are approximately 1% of peak concentrations observed following IV administration (500 mg); systemic absorption of aztreonam following inhaled administration is expected to be minimal; there are no data on effects of drug on breastfed infant or effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for therapy and any potential adverse effects on the breastfed infant from drug or from underlying maternal condition

Interactions

Adverse Effects

Side effects of Aztreonam inhalation : >25% Cough (54%) 10-25% Nasal congestion ( 16%) Wheezing (16%) Pharyngolaryngeal pain (12%) Pyrexia (13%) 1-10% Chest discomfort (8%) Abdominal pain (7%) Vomiting (6%) Bronchospasm (3%) Rash (2%)

Mechanism of Action

Inhibits cell wall synthesis by binding to penicillin binding protein 3, which in turn inhibits cell wall biosynthesis; member of monobactam family