The mode of administration of surfactant is

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Pharmacology

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2022

Explanation

Surfactant is a lipoprotein complex that reduces surface tension within the alveoli of the lungs, preventing them from collapsing during expiration.
To be effective, it must be delivered directly to its site of action, the inner surface of the alveoli.
The endotracheal route, via an endotracheal tube or a thin tracheal catheter, is the standard method to ensure the medication is instilled directly into the lungs.
This is the primary treatment for Respiratory Distress Syndrome (RDS) in premature neonates who lack sufficient natural surfactant.

Option A: The subcutaneous route delivers medication into the fatty tissue for slow systemic absorption. Surfactant needs to act locally in the lungs and would not reach its target site via this route.
Option B: The intravenous route administers drugs directly into the bloodstream for systemic distribution. Surfactant is not designed for systemic circulation and would be ineffective if given this way.
Option C: The intrathecal route involves injecting medication into the spinal canal. This is used for targeting the central nervous system and has no application for treating a lung condition.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Route of Administration for Pulmonary Surfactant as background academic context rather than a clinical decision trigger.
Endotracheal surfactant administration is a life-saving intervention for premature infants with Respiratory Distress Syndrome (RDS), significantly reducing mortality and morbidity.
Nurses play a critical role in preparing the infant, assisting with the procedure, and monitoring for immediate effects, such as improved oxygenation and lung compliance, as well as potential adverse effects like transient hypoxia or bradycardia.
What if? If a premature infant is breathing spontaneously but still requires surfactant, a less invasive technique like LISA (Less Invasive Surfactant Administration) or the InSurE (INtubate-SURfactant-Extubate) method may be used. This involves passing a thin catheter into the trachea to deliver the surfactant without requiring prolonged mechanical ventilation, reducing the risk of ventilator-induced lung injury.

How to Approach the Question

First, identify the core of the question: it asks for the administration route of a specific drug, surfactant.
Recall the function and target organ of surfactant. Surfactant acts locally inside the lungs to keep the alveoli open.
Analyze the given options based on their delivery sites.
Eliminate routes that provide systemic absorption (Subcutaneous, Intravenous) as surfactant needs to be at a specific local site.
Eliminate the Intrathecal route, as it targets the central nervous system, which is irrelevant to lung function.
Conclude that the Endotracheal route is the only logical choice, as it delivers the drug directly into the trachea and subsequently to the lungs.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 156-158

E6 Obstetrics Williams p. 27-46

E6 Nursing Fundamentals Taylor p. 840-842