Nurses Compass
Drug Guide
Indacaterol Maleate
Classification
Therapeutic: Bronchodilator for COPD
Pharmacological: Beta-2 adrenergic agonist
FDA Approved Indications
- Maintenance treatment of bronchospasm associated with COPD
Mechanism of Action
Indacaterol is a long-acting beta-2 adrenergic agonist that relaxes airway smooth muscle by stimulating beta-2 receptors, leading to bronchodilation.
Dosage and Administration
Adult: 75 mcg once daily via inhalation using Neohaler device
Pediatric: Not indicated for pediatric use
Geriatric: Use with caution; monitor for cardiovascular effects; no specific dosage adjustment required
Renal Impairment: No specific adjustment recommended
Hepatic Impairment: Use with caution; limited data available, adjust as necessary
Pharmacokinetics
Absorption: Rapid absorption after inhalation
Distribution: Widely distributed in tissues, protein binding about 50%
Metabolism: Partially metabolized in the liver, primarily via CYP450 enzymes
Excretion: Excreted mainly via feces; minimal renal excretion
Half Life: Approximately 34 hours, allowing once-daily dosing
Contraindications
- Hypersensitivity to indacaterol or any component of the formulation
Precautions
- Use with caution in patients with cardiovascular disease, tremor, or hyperthyroidism; monitor for paradoxical bronchospasm
Adverse Reactions - Common
- Upper respiratory tract infection (Common)
- Cough (Common)
- Headache (Common)
Adverse Reactions - Serious
- Paradoxical bronchospasm (Serious—rare)
- Cardiovascular effects (e.g., tachycardia, arrhythmias) (Serious—rare)
Drug-Drug Interactions
- Other long-acting beta-2 agonists, beta-blockers (may diminish efficacy)
Drug-Food Interactions
- None specific
Drug-Herb Interactions
- None established
Nursing Implications
Assessment: Assess respiratory status and auscultate lungs before and periodically during therapy; monitor for paradoxical bronchospasm.
Diagnoses:
- Impaired gas exchange related to bronchospasm
- Risk for decreased cardiac output related to cardiovascular stimulation
Implementation: Administer via inhalation once daily; instruct patient on proper inhaler technique; monitor for adverse effects.
Evaluation: Evaluate effectiveness by assessing improved respiratory symptoms and lung function.
Patient/Family Teaching
- Use daily as prescribed; do not double doses.
- Report new or worsening cough, chest pain, or irregular heartbeat.
- Carry quick-relief inhaler for rescue use.
- Avoid excessive use of bronchodilators.
Special Considerations
Black Box Warnings:
- None currently
Genetic Factors: None well established
Lab Test Interference: None known
Overdose Management
Signs/Symptoms: Severe tachycardia, hypertension, hypokalemia, tremors, chest pain
Treatment: Discontinue drug, monitor cardiovascular status, provide supportive care as needed, and treat symptoms accordingly.
Storage and Handling
Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F); protect from moisture and heat.
Stability: Stable within specified storage conditions, follow manufacturer guidelines.