DTP Fentanyl Flashcards
Fentanyl Drug class
Narcotic analgesic
Fentanyl Pharmacology
- Synthetic narcotic analgesic
- Acts on the CNS
- Binds with the opioid receptors
Fentanyl Metabolism
Hepatic metabolism and renal excretion
Fentanyl Indications
- Significant pain
- Morphine KSAR
Fentanyl Contraindications
- KSAR or hypersensitivity to fentanyl
Contraindications for Fentanyl NAS administration
- GCS <14
- Suspected nasal or mid fractures
- Blood or mucous obstructing the nasal passage
Fentanyl Precautions
- Elderly pts
- Hypotension
- Respiratory tract burns
- Respiratory depression and/or failure
- Known addiction to narcotics
- Patients taking MAOIs
Fentanyl Side Effects
- Drowsiness
- Pin point pupils
- Bradycardia
- Hypotension
- Respiratory depression
- Muscular rigidity (particularly muscles of respiration)
- Nausea
- Vomiting
Fentanyl Presentation
100 mcg/2 mL
Fentanyl Onset
Fentanyl Duration
30-60min
Fentanyl Half-life
2-3hrs
Fentanyl Schedule
S8 - controlled drug
Fentanyl Special notes
• Fentanyl is a rapid onset synthetic narcotic that may potentiate respiratory depression and haemodynamic instability, particularly when administered intravenously in the setting of CNS depression or hypovolaemia.
Fentanyl IM Adult >70yo dose for Significant Pain
25-50mcg, repeat up to 50mcg
@10min, TMD 100mcg
Fentanyl IM dose Adult
25-100mcg, repeat up to 50mcg @10min, TMD 200mcg
Fentanyl IV dose Adult >70yo dose for Significant Pain
25mcg, repeat @5min, Total Max dose 100mcg
Fentanyl Paediatric dose for Significant Pain
> 1y = 1.5mcg/kg NAS
1mcg/kg @ 10mins
Total Max 100mcg
<1 = medical consult
NAS administration is ≤ 0.5 mL per nostril, although volumes up to 1 mL per nostril may be considered appropriate
Special notes of Fentanyl and Midazolam administration
- Address any adverse side effects such as hypotension when administering fentanyl and midazolam to maintain sedation
- Fentanyl addition will reduce midazolam requirements, provide analgesia and ultimately decrease the risk of hypotension.
- Under no circumstances are fentanyl and midazolam to be mixed in the one syringe.
Fentanyl IV dose for Adult
25mcg, repeat @5min, Total Max dose 200mcg
Special notes of Fentanyl doses above 200mcg
- For doses above 200 mcg, IV access must be obtained and fentanyl administered via that route.
- If intravenous access is not able to be obtained and greater than 200 mcg is required, paramedics must seek medical consultation and approval via the QAS on-call medical officer consultation line.
Special notes of Fentanyl administration of hypotensive patient
- When administered to hypotensive patient, ACPs must call for ICP backup where available.
- In the setting of the hypotensive adult patient (SBP
