Aztreonam

The Aztreonam inhaler is a prescription medication that remedies lung infections for individuals who have cystic fibrosis.

Overview

The medication within the aztreonam inhaler is inhaled into the patient’s lungs by mouth to combat infections that are caused by the bacteria known as pseudomonas aeruginosa. Aztreonam stops the progression of, and eventually kills, bacteria. This inhaler will not be effective for addressing the flu, virus infections, or colds. Aztreonam can only be obtained with a prescription from your physician. This medication is offered in powder form for solution and should only be used with an inhaler.

Condition(s) treated?

  • Lung infections for cystic fibrosis patients

Type of medicine?

  • Inhaler for lung infections

Side Effects

Medications can sometimes cause undesirable side effects for patients in addition to the benefits they provide. If the following side effects take place, they may require medical care; however, not all of these may take place.

Consult your physician right away if these side effects occur:

More Common Side Effects – Medical Care Required

  • Fever
  • Difficulty breathing
  • Cough
  • Chest pain/discomfort

Less Common Side Effects – Medical Care Required

  • Loud breathing
  • Chest tightness
  • Breath shortness

Occasionally, side effects take place that will not require medical care. These may resolve themselves and disappear as treatment progresses as the body becomes more accustomed to the medication. In addition, your doctor can share ways to reduce or prevent certain side effects. Consult your physician if you have questions regarding the subsequent side effects, especially if they become troublesome or prolonged.

More Common Side Effects – Medical Care Not Required

  • Stomach pain
  • Abdominal pain
  • Sore throat
  • Stuffy nose
  • Vomiting

Less Common Side Effects – Medical Care Not Required

  • Rash

Patients may experience additional side effects that are not listed here. If the patient observes additional side effects, consult your physician. Side effects can be reported to the FDA at 1-800-FDA-1088.

Dosage

It is important to read and understand the patient medication booklet that your pharmacist will provide you with prior to using this medicine and when a refill is needed. Aztreonam is a medicine that is combined with a special piece of equipment (nebulizer) that transforms the mixture into a fine mist for inhalation.

Be sure that you are familiar with all directions for this medicine use and for the nebulizer use. Children may need assistance when using this medicine, as it can be a complex process to use correctly. Any questions regarding proper use for this medication should be directed at your physician, respiratory therapist, or pharmacist.

Proper Use

This medication should only be taken according to the instructions given to you by your physician. Never take more of this medication than prescribed, never take it more frequently than prescribed, and never keep and take the medication longer than the physician intended. This medication must be used throughout the entire time of treatment, even if the patient feels much better after just a couple of doses. The infection cannot be completely cleared out if the prescription is not taken for long enough.

Only use the Altera® Nebulizer System with aztreonam. The nebulizer and inhaled liquid both come with medication summaries and patient directions. Carefully read and be sure that you understand the directions completely. Consult your physician with any questions regarding this medication or how to use it. Your physician could possibly give the patient additional drugs to use prior to aztreonam, these tend to be mucolytics or bronchodilators. Mucolytics work to keep the mucus from accumulating in the lungs. Bronchodilators work to open the lungs to make breathing easier for the patient. Be sure to follow the directions from your physician carefully regarding how to use aztreonam. This medication works best if all medications taken are used in the proper order.

Inhalation Solution Directions for Use:

  1. Combine the powder in the glass vial (container) with the diluent liquid or saline.
  2. Gradually swirl the container so that the powder becomes dissolved. After dissolved, discard dose and mix a new one if the liquid from the vial has specks within the liquid or it is cloudy.
  3. Put the liquid in the medication nebulizer cup or reservoir immediately.
  4. Do not use the liquid from the nebulizer to mix other medications.
  5. Immediately take the dose after mixing.
  6. Breathe the medication in through the nebulizer mouthpiece.
  7. Use the nebulizer until the liquid has dissipated (about 2 to 3 minutes).
  8. Discard the saline container, rubber stopper, and empty vial after every use.
  9. Sanitize nebulizer after every use.

Dosing Information

Individual patients will have different dosing information that they receive from their doctor. Follow the instructions by your physician, or follow the instructions on the medication container. The following data contains just the average dose of aztreonam. If the dose you have been given varies from what is listed here, do not adjust your dose unless your physician instructs you to.

The total dose of medication that you are prescribed is dependent on the strength of the aztreonam. The quantity of doses taken per day, how long it takes to take the medication, and the time between each dose will depend directly on the medical issue, or the reason the patient needs the medication.

Dosage Information (Inhalation solution in nebulizer)

For individuals with lung illnesses:

Adults, children 7 and older, and teenagers – Dose is one 75 milligrams (mg) container 3x daily for 28 days. Doses should not be taken less than 4 hours from when another dose was taken.

Children under 7: Physician must determine dose.

Missed Dose

Try not to miss a dose of aztreonam; but if it is done accidentally, be sure to take it right away. Follow this guideline unless it is closer to the next scheduled dose; in this case, skip the dose that was overlooked and return to the normal dosing schedule. Never double doses of aztreonam. If the patient misses the dose, all of the daily doses can still be taken if there are more than four hours between the doses.

Interactions

Drug Interactions

While in certain instances, medications should never be combined; other circumstances will allow for two medications to be taken at the same time, despite the possibility of an interaction taking place. In cases where it is OK to combine medications, physicians may want to adjust the dose or take additional precautions. While taking aztreonam, inform your medical professional if you already taking any of the following drugs. The following medications make up a list of significant interactions, but this list is not all-encompassing.

When taking aztreonam, patients are typically not prescribed the following drugs in addition. Some circumstances may make it necessary to take both medications. For patients who have both medications prescribed at the same time, the physician may adjust the frequency or amount of dose for both medications.

  • Cholera Vaccine (Live)

Other Interactions

Some medications should not be taken near mealtime, as various medications can have negative effects when combined with particular types of food. Discuss these potential interactions with your doctor, and find out how the medication impacts your normal eating, tobacco, and alcohol habits.

Other Medical Interactions

Be sure to inform your physician of any other medical issues, as they can impact the use and effectiveness of this medication. Disclose any medical issues to your medical professional, specifically:

  • Penicillin allergy
  • Cephalexin allergy
  • Cefuroxime allergy
  • Cefdinir allergy
  • Bronchospasm (or history of) – Take caution, can agitate symptoms
  • Beta-lactam allergy
  • Augmentin® allergy
  • Amoxil® allergy
  • Amoxicillin allergy

Warnings

When determining whether or not a medication is right for you, one should compare the risks of the drug against the benefits it will bring to the patient. The patient must weigh the pros and cons with their doctor and figure out together if the medication is right for them.

Patients should inform their physicians if they have ever had any allergic or odd reactions to this medication or any other medication. Also inform your physician if you have allergies of any kind, such as to animals, preservatives, dyes, or foods. Be sure to carefully read and ensure you understand the ingredients and package label.

It is vital to have your physician monitor the advancement of the patient regularly. Doing so will ensure your doctor is aware of how your body is responding to the medication and to safeguard against unwanted side effects.

Coughing, wheezing, breath shortness, or struggling while breathing after taking this medication is a sign that medical care is required immediately. This medication can trigger bronchospasm, a potentially life-threatening condition.

If a rash begins to appear on the skin, do not continue to use this medication and consult your physician immediately. Swelling on the face, allergic reactions, hives, or throat tightness are signs of negative reactions; medical care is required if symptoms do not get better.

There can also be negative reactions that occur after the use of aztreonam. These occurrences have been willingly reported from a population of undetermined size, and therefore there is currently no estimation of occurrence rate.

  • Arthralgia (swelling of joints)
  • Musculoskeletal and connective tissue disorders

Specific Demographic Use

Pediatric

There have not been any suitable studies as to the effects of aztreonam on children under seven years old. It has not yet been established whether or not aztreonam is safe and effective for children.

Geriatric

It has not yet been researched whether or not aztreonam is useful in treatment for elderly patients.

Pregnancy

Aztreonam is a medication that impacts the body in one of two ways in regards to pregnancy. Either there has been no evidence of harm to the fetus as examined through animal studies, and there has not been similar research completed in women; or a dangerous effect was observed in animal studies, but similar research in pregnant women has not confirmed any danger to the fetus.

Breastfeeding

Aztreonam has been shown to present an insignificant risk to the infant when taken by a women who is breastfeeding.

Storage

This medication should be stored out of children’s grasp. Do not keep medication longer than it is needed. Do not keep outdated medication. Consult your physician regarding how unused medication should be disposed of. The saline ampules and vials (unopened) should be kept in the refrigerator, in their original container. The unopened containers can also be kept at room temperature (as long as they are out of direct heat and light) for no more than 28 days. The liquid combination should not be kept once the powder in the mixture has been dissolved.

Summary

Individuals with cystic fibrosis can benefit from taking aztreonam, as it is an inhaler for those with lung infections. The powder within the aztreonam inhaler is breathed into the patient’s lungs through the mouth to fight infections that are caused by pseudomonas aeruginosa bacteria. Aztreonam inhibits the progression of bacteria and eventually kills it. Patients interested in taking aztreonam should consult their doctor to find out if this medication is appropriate for them. If patients experience coughing, chest pain and/or trouble breathing, they should seek medical care immediately. Prior to taking aztreonam, patients must inform their medical professional if they are taking any other medications. They should also inform their doctor of medical issues they may have. Both of these aspects can impact the effectiveness and use of aztreonam.

Resources
Last Reviewed:
December 25, 2017
Last Updated:
February 09, 2018
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