Fentanyl

Question 1

What is the mechanism of action of Fentanyl?

Answer 1

Fentanyl is an opiate analgesic, it is an opiate agonist that binds to opiate receptors in the brain and spinal cord resulting in analgesia.

Question 2

What are the indications for Fentanyl?

Answer 2

●Moderate to severe pain.
●Cardiogenic Pulmonary Odema with severe anxiety.
● For pain, agitation, and shortness of breath during end of life care.
●RSI.
●Sedation post intubation.

Question 3

What are the contraindications of Fentanyl?

Answer 3

Known severe allergy.

Question 4

What are the cautions for Fentanyl? (7)

Answer 4

●Altered level of consciousness (Fentanyl may further reduce this).
●Aged less than 1 year old, increased risk of respiratory depression.
●Respiratory depression or at high risk of respiratory depression such as severe COPD, morbid obesity, or on home BiPAP.
●Labour. May cause drowsiness or respiratory depression in the baby particularly when administered within an hour or 2 of birth.
●Concurrent administration of other opiates such as Ketamine or Midazolam (will increase and prolong effects).
●75 years old or greater particularly if frail (will increase and prolong effects).
●Signs of shock (may worsen shock).

Question 5

What is the IV dose for Fentanyl for an adult?

Answer 5

10-50mcg every 5 minutes as required.
If frail or has signs of shock administer a low dose.

Question 6

What is the adult IM/Subcut dose of Fentanyl?

Answer 6

●50-100mcg can be repeat every 20mins for a total of 3 doses.

Question 7

What are the side effects of Fentanyl?

Answer 7

●Respiratory depression.
●Bradycardia.
●Hypotension.
●Sedation.
●Nausea and vomiting.
●Itch.
●Euphoria.