Zafirlukast (Accolate) Drug Study

Generic Name : zafirlukast

Brand Name: Accolate

Classification: Antasthmatic, Leukotriene receptor antagonist

Pregnancy Category B

Dosage & Route

Available forms : Tablet—10, 20 mg

ADULTS AND CHILDREN > 12 YR

• 20 mg PO bid on an empty stomach.

PEDIATRIC PATIENTS 5–11 YR

• 10 mg PO bid on an empty stomach.

Therapeutic actions

• Zafirlukast selectively antagonizes the leukotriene D4 receptor. It inhibits bronchoconstriction caused by various inhaled antigens or irritants. It is not used in acute asthma attacks.

Indications

• Prophylaxis and long-term treatment of bronchial asthma in adults and children > 5 yr
• Unlabeled use: Chronic urticaria

Adverse effects

• GI disturbances, headache, myalgia, generalized pain, fever, dizziness, raised LFT, respiratory tract infections, hypersensitivity reactions, Churg-Strauss syndrome.
• Potentially Fatal: Severe hepatotoxicity.

Contraindications

• Hypersensitivity, hepatic impairment, cirrhosis, acute asthmatic attacks. Lactation.

Nursing considerations

Assessment

• History: Hypersensitivity to zafirlukast; impaired renal or hepatic function; pregnancy, lactation; acute asthma or bronchospasm
• Physical: T; orientation, reflexes; R, adventitious sounds; GI evaluation; LFTs, renal function tests

Interventions

• Administer on an empty stomach 1 hr before or 2 hr after meals.
• Ensure that drug is taken continually for optimal effect.

Teaching points

• Take this drug on an empty stomach, 1 hour before or 2 hours after meals.
• Take this drug regularly as prescribed; do not stop taking it during symptom-free periods; do not stop taking it without consulting your health care provider.
• Do not take this drug for acute asthma attack or acute bronchospasm; this drug is not a bronchodilator; routine emergency procedures should be followed during acute attacks.
• Avoid use of over-the-counter medications while using this drug; many of them contain products that can interfere with drug or cause serious side effects. If you think that you need one of these products, consult your health care provider.
• You may experience these side effects: Dizziness (use caution when driving or performing activities that require alertness); nausea, vomiting (eat frequent small meals); headache (analgesics may be helpful).
• Report fever, acute asthma attacks, severe headache.