Fentanyl

Question 1

Presentation

Answer 1

100mcg in 2ml

250mcg In 1ml

Question 2

Indications

Answer 2

1. Sedation for facilitating intubation
2. Sedation to maintain ETT
3. Sedation for cardioversion
4. Sedation for pacing
5. Sedation for CPR interfering pt
6. Analgesia
   - Allergy to Morphine
   - Hypotension
   - Nausea and Vomiting
   - Short duration of action
   - Known renal impairment or failure
   - Headache

Question 3

Contraindications

Answer 3

1. Hypersensitivity

2. Late 2nd stage labour

Question 4

Precautions

Answer 4

1. Elderly/frail
2. Asthma
3. Respiratory depression
4. Hepatic impediment/ failure
5. Known addict
6. Pts on MOI
7. Facial trauma - IN

Question 5

Side effects

Answer 5

1. Respiratory depression
2. Apnoea
3. Rigidity of intercostals and diaphragm
4. Bradycardia

Question 6

Pharmacology

Answer 6

Fentanyl is a synthetic opioid analgesic which works on the opioid receptors in the brain specifically MU, KAPPA, DELTA and SIGMA. CNS effects include analgesia (depression), respiratory depression leading to apnoea and addiction. CVS effects include decreased conduction through AV node.

Question 7

Metabolism

Answer 7

Metabolised by the liver

Question 8

Excretion

Answer 8

Excreted by the kidneys

Question 9

IV effects

Answer 9

Onset - immediate
Peak - <5mins
Duration - 30-60mins

Question 10

IN effects

Answer 10

Peak - 2mins