Fentanyl Flashcards
What is fentanyl?
Strong opioid
What is the mechanism of action of fentanyl?
Acts as an agonist for the opioid μ receptor
How does fentanyl compare to morphine?
Produces similar (but weaker) effects
What are the routes of delivery of fentanyl?
- PO
- IV
- Topical (film, patch, spray)
Is fentanyl the only opioid that can be administered by patch?
No , buprenorphine patches exist
How often are buprenorphine patches changed?
Once a week
How often are fentanyl patches changed?
Every 72 hours
Are fentanyl preparations for breakthrough pain interchangeable?
No
What are the indications for fentanyl?
- Severe chronic pain
- Breakthrough pain
What are the contraindications to fentanyl?
Same as morphine
Who should fentanyl be used with caution in?
- Impaired consciousness
- Cerebral tumours
- Mucositis
Why should fentanyl be used with caution in impaired consciousness or cerebral tumours?
Can worsen CNS depression in these conditions
Why should fentanyl be used with caution with people with mucositis?
Oral absorption can be altered
What monitoring is required with fentanyl?
Monitor pain relief at least every 24 hours after altering dose, to allow analgesic effect to occur
What might interact with fentanyl?
Triazole anti-fungals
What might happen if fentanyl is given with triazole anti-fungals?
Increased plasma concentration of fentanyl
What are the common side effects of fentanyl?
- Application site reactions
- Abdo pain, nausea, GORD, and appetite changes
- Dyspnoea and respiratory depression
- Drowsiness
- Hypertension
What are the uncommon side effects of fentanyl?
- Amnesia
- Arthralgia
- Ileus
What are the rare side effects of fentanyl?
Hiccups
What side effects can IV fentanyl cause?
Muscle rigidity
How can muscle rigidity caused by IV fentanyl be managed?
Neuromuscular relaxants
What should patients with fentanyl patches avoid doing?
Exposing patch to external heat, e.g. saunas, hot baths
What patient counselling is required with fentanyl?
- How to apply patches
- Drowsiness and impairment of normal activities
How should fentanyl patches be applied?
To dry, hairless areas of skin, and then removed and changes after 72 hours
