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 asthmaneutrophil and eosinophil
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
Prophylais and chronic treatment of asthma in adults and children ! "# mo
$elief of symptoms of seasonal allergic rhinitis in adults and children ! # yr
%nlabeled uses& 'hronic urticaria, atopic dermatitis
Contraindications and cautions
'ontraindicated with hypersensitivity to montelukast or any of its components(
acute asthma attacks( status asthmaticus.
%se cautiously with pregnancy and lactation.
Available forms
Tablets") mg( chewable tablets*, + mg( granules* mg,packet
Dosages
ADULTS AND ATI!NTS " #$ %&
-ne ") mg tablet P- daily, taken in the evening.
!DIAT&IC ATI!NTS
1223 mo (asthma only): * mg granules P- daily, taken in the evening.
25 yr: -ne *.mg chewable tablet P- daily, taken in the evening.
614 yr: -ne +.mg chewable tablet P- daily, taken in the evening.
harmacokinetics
Route Onset Peak
-ral $apid #/* hr
Metabolism: 0epatic( T",#& #.1/+.+ hr
Distribution: 'rosses placenta and enters breast milk
Excretion: 2eces, urine
Adverse effects
CNS: 0eadache, di33iness
GI: 4ausea, diarrhea, abdominal pain, dental pain
Respiratory: 5nfluen3a, cold, nasal congestion
Other: 6enerali3ed pain, fever, rash, fatigue
Interactions
Drug-drug
7ecreased effects and bioavailability if taken with phenobarbital, rifampin(
monitor patient and ad8ust dosage as needed
Nursing considerations
Assessment
History: 0ypersensitivity to montelukast or any of its components( acute asthma
attacks( status asthmaticus, pregnancy and lactation
Physical: T( orientation, reflees( $, adventitious sounds( 65 evaluation
Interventions
Administer in the evening without regard to food.
9nsure that drug is taken continually for optimal effect.
7o not administer for acute asthma attack or acute bronchospasm.
Avoid the use of aspirin or 4SA57s in patients with known sensitivities while
they are using this drug.
9nsure 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. 'ontinue taking any other antiasthma drugs that have been
prescribed for you. 4otify your health care provider if your asthma becomes
worse.
7o 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 4SA57s if you have a known sensitivity to these
drugs. :ontelukast will not prevent reactions.
These side effects may occur& 7i33iness ;use caution when driving or performing
activities that re<uire alertness if these effects occur=( nausea, vomiting ;eat
fre<uent small meals, take drug with food=( headache ;analgesics may be
available=.
$eport fever, acute asthma attacks, flulike symptoms, lethargy.
Adverse effects in Italic are most common( those in ol! are life.threatening.