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(zill-LOO-tuhn)
Zyflo
Class: Leukotriene receptor inhibitor

 Action Attenuates bronchoconstriction by inhibiting leukotriene-dependent smooth muscle contractions.

 Indications Prophylaxis and chronic treatment of asthma.

 Contraindications Active liver disease; elevations in transaminases greater than or equal to three times the upper limit of normal.

 Route/Dosage

ADULTS & CHILDREN ³ 12 YR: PO 600 mg qid.

 Interactions Propranolol, theophylline, warfarin: Effects of these agents may be increased.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Pain; dizziness; insomnia; somnolence; malaise; nervousness; hypertonia. EENT: Conjunctivitis. GI: Abdominal pain; dyspepsia; nausea; vomiting; constipation; flatulence. GU: Urinary tract infection; vaginitis. HEPA: Elevated liver function tests. OTHER: Asthenia; myalgia; arthralgia; chest pain; fever; lymphadenopathy; muscle rigidity; pruritis.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in pediatric patients < 12 yrs of age not established. Acute asthma attacks: Not indicated for treatment of acute asthma attacks. Continue therapy during acute exacerbations of asthma. Hepatotoxicity: Elevations in liver function tests may occur. Use with caution in patients who consume substantial quantities of alcohol or who have history of liver disease. Monitor hepatic transaminases at initiation of, and during therapy. Hematologic: Transient decreases in WBCs may occur.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Available only in PO form.
  • Store tablets at room temperature (20° to 25°C; 68° to 77°F).
  • Keep in tightly sealed container, protected from light.
  • May be taken with meals and at bed time.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note history of liver disease or alcohol consumption.
  • Assess patient’s respiratory status prior to and during therapy.
  • Ensure that liver function tests are monitored during therapy.
  • Monitor patient medication for effectiveness and side effects, including signs and symptoms of liver dysfunction.

 Patient/Family Education

  • Inform the patient that this medication is for long-term treatment of asthma.
  • Instruct patient to take the medication exactly as prescribed even when they are free of symptoms.
  • Advise patient to take medication 4 times/day with each meal and at bedtime.
  • Warn the patient that this is not a bronchodilator and should not be used for the treatment of acute asthma attacks. However, advise the patient to continue during acute asthma attacks.
  • Instruct the patient to continue to take other asthma medications as prescribed.
  • Instruct the patient to avoid taking other medication, including otc, without discussing it with his/her health care provider.
  • Advise patient that elevation of liver enzyme is most serious side effect and that he/she must have liver function tests periodically. Instruct the patient to notify his/her health care provider if experiencing any signs or symptoms of liver disease: Flu-like symptoms; nausea; right upper quadrant pain; fatigue; lethargy; pruritis; jaundice.
  • Instruct patient to notify health care provider if the use of short-acting bronchodilators increases or if more than the maximal number of inhalations of short-acting bronchodilators are needed.

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