MONTELUKAST SODIUM Pregnancy Category B Drug Classes Antiasthmatic drug Leukotriene receptor antagonist Therapeutic actions Selectively and

nd competitively blocks the receptor that inhibits leukotriene formation, thus blocking many of the signs and symptoms of asthma--neutrophil 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 Prophylaxis and chronic treatment of asthma in adults and children > 6 y Contraindications/cautions Contraindicated in the presence of hypersensitivity to montelukast or any of its components; acute asthma attacks; status asthmaticus. Use caution in the presence of pregnancy and lactation. Dosage Available Forms: Tablets--10 mg; chewable tablets--5 mg Adults and Children > 15 Y One 10 mg tablet PO qd, taken in the evening. Pediatric 6---14 Y One 5 mg chewable tablet PO qd, taken in the evening. Pharmacokinetics Route Onset Peak Oral Rapid 2---4 h Metabolism: Hepatic; T: 2.7---5.5 h 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 Clinically important drug-drug interactions Decreased effects and bioavailability if taken with phenobarbital, rifampin; 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 Implementation Administer in the evening without regard to food. Assure 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 on this drug. Assure that patient has a readily available rescue medication for acute asthma attacks or situations when a short-acting inhaled agent is needed. Drug-specific 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 antiasthma drugs 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. Know that the following side effects may occur: dizziness (use caution when driving or performing activities that require alertness if these effects occur); nausea, vomiting (small, frequent meals may help, taking the drug with food may also help); headache (analgesics may be helpful). Avoid the use of aspirin or NSAIDs if you have a known sensitivity to these drugs. Montelukast will not prevent reactions. Report: fever, acute asthma attacks, flu-like symptoms, lethargy. Adverse effects in Italic are most common; those in Bold are life-threatening.