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Adverse Reactions During the dosing procedure: Cardiovascular: Transient bradycardia Respiratory: Oxygen desaturation Rare but important or life-threatening: Apnea, endotracheal tube blockage, hypercarbia, hyper-/hypotension, post-treatment nosocomial sepsis probability increased, pulmonary air leaks, pulmonary interstitial emphysema, vasoconstriction Precautions Use of beractant in infants <600 g birth weight or >1750 g birth weight has not been evaluated Warnings Rapidly affects oxygenation and lung compliance and should be restricted to a highly supervised use in a clinical setting with immediate availability of clinicians experienced with intubation and ventilatory management of premature infants. If transient episodes of bradycardia and decreased oxygen saturation occur, discontinue the dosing procedure and initiate measures to alleviate the condition; produces rapid improvements in lung oxygenation and compliance that may require immediate reductions in ventilator settings and FiO 2 . Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) There are no known significant interactions. Pregnancy Implications Beractant is only indicated for use in premature infants. Monitoring Parameters Continuous heart rate and transcutaneous O 2 saturation should be monitored during administration; frequent ABG sampling is necessary to prevent postdosing hyperoxia and hypocarbia. Mechanism of Action Replaces deficient or ineffective endogenous lung surfactant in neonates with respiratory distress syndrome (RDS) or in neonates at risk of developing RDS. Surfactant prevents the alveoli from collapsing during expiration by lowering surface tension between air and alveolar surfaces. Use of UpToDate is subject to the Subscription and License Agreement . Topic 13040 Version 31.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.4 - C21.36 Licensed to: Southeast Alabama Med Ctr | Support Tag: [0504-201.211.0.116-E259C7487F-S244013.14]