Alfentanil

Question 1

What is the trade name of Alfentanil?

Answer 1

Alfenta

Question 2

What is the formal drug class of Alfentanil?

Answer 2

tetrazole derivative of fentanyl

analgesic and opioid receptor agonist

Question 3

What are the uses of Alfentanil?

Answer 3

• rapid onset makes it ideal for analgesia when noxious stimulation is acute, but transient, as associated with laryngoscopy, tracheal intubation, and performance of a retrobulbar block
• analgesic adjunct in the maintenance of anesthesia with barbiturates or N2O or as primary anesthetic agent for the unduction of anesthesia

Question 4

What is the MOA of Alfentanil?

Answer 4

mu-opioid receptor agonist
mu, kappa, delta
-drug binds to stereospecific receptors at many sites within the CNS, increases the pain threshold, alters pain perception and inhibits ascending pain pathways

Question 5

What is the onset of action of Alfentanil?

Answer 5

RAPID- effect site equilibration time is 1.4 minutes

Question 6

What is the DOA of Alfentanil?

Answer 6

30 - 60 minutes

Question 7

How is Alfentanil metabolized?

Answer 7

N-dealkylation and O-demethylation in the liver to form inactive metabolites

Question 8

What is the major metabolite? is it active?

Answer 8

Noralfentanil, it is NOT active

Question 9

What is the elimination 1/2 life of Alfentanil?

Answer 9

83 - 97 minutes (1.5 hrs)

Question 10

What is the Vd of Alfentanil?

Answer 10

4 - 6 times smaller than Fentanyl. This is due to lesser lipid solubility and higher protein binding

0.46 L/kg

Question 11

Is Alfentanil protein bound?

Answer 11

92% protein bound

Question 12

What are the CNS effects of Sufentanil?

Answer 12

-muscle rigidity of neck, extremeties, chest wall, abdomen,

Question 13

What are the Resp side effects of Sufentanil?

Answer 13

• respiratory depression

- apnea

Question 14

What are the CV effects of Sufentanil?

Answer 14

unchanged generally

Question 15

What are theGI side effects of Sufentanil?

Answer 15

N/V

increase in biliary tract pressure

Question 16

What type of drugs may increase levels of sufentanil?

Answer 16

CYP3A4

Question 17

What is the analgesia dose of Alfentanil?

Answer 17

5 - 30 mcg/ kg (followed by infusion of 0.4 - 1.7 mcg/kg/min)

Question 18

What is the induction dose of Alfentanil?

Answer 18

50 - 200 mcg/kg

Question 19

What is Alfentanil an analogue of?

Answer 19

Fentanyl

Question 20

____% exists in an unionized state= ?

Answer 20

90%= VERY rapid onset (1.4 min compared to Fentanyl, 6.8 min and sufentanil 6.2 min)

Question 21

Is alfentanil highly protein bound?

Answer 21

YES, but highly diffusable

Question 22

Is alfentanil’s diffusion fraction higher, lower, or the same as fentanyl? Why is this weird?

Answer 22

HIGHER diffusible fraction than Fentanyl despite more intense protein binding

Question 23

____ as potent as Fentanyl? _____-___ x more potent than morphine

Answer 23

1/5th; 10 -20

Question 24

What is the clinical significance of Alfentanil?

Answer 24

• rapid onset is useful for blunting hemodynamic response to noxious stimuli
• rapid effect due to 90% of drug in non-ionized form
• used as infusion for outpatient surgery

Question 25

What is the dosage of Alfentanil?

Answer 25

10 -20 mcg/kg

Question 26

What isthe infusion rate of Alfentanil?

Answer 26

0.25 - 0.75 mcg/kg/min

Question 27

What is the loading dose of Alfentanil?

Answer 27

25 - 100mcg/kg

Question 28

What is the maintenance infusion rate of Alfentanil?

Answer 28

0.5 - 2 mcg/kg/min

Question 29

What are the additional bolus doses of Alfentanil?

Answer 29

5 - 10 mcg/kg