Fentanyl

Question 1

How does Fentanyl Present?

Answer 1

100mcg/2mL

Question 2

How should Fentanyl be made

Answer 2

Diluted with 8mL saline

Question 3

What are the pharmacodynamics of Fentanyl

Answer 3

• Binds to Delta, Kappa and Mu receptors
• Antagonises to stimulate pain centres in CNS and Spinal Cord

Question 4

Contraindications of Fentanyl

Answer 4

• Late 2nd stage Labour
• Hypersensitivity
• MAOIs within 14days
• Serotonin Syndrome

Question 5

Fentanyl Precautions (5 things)

Answer 5

1. Elderly/Frail patients
2. Impaired Hepatic function
3. Respiratory Depression (COPD)
4. Current Asthma
5. Rhinitis, Rhinorrhoea or facial trauma (IN route)

Question 6

Fentanyl Adverse effects

Answer 6

• Respiratory Depression
• Apnoea
• Rigidity of doaphragm and intercostal muscles
• Bradycardia

Question 7

When is the onset of fentanyl?

Answer 7

<5minutes for IN, IM, IV

Question 8

Why is Fentanyl contraindicated in MAOIs

Answer 8

• Can lead to serotonin syndrome. Fentanyl increases serotonin levels in synaptic cleft and MAOIs stop the enzymatic breakdown of serotonin

Question 9

Why is Fentanyl contraindicated in serotonin syndrome

Answer 9

• Fentanyl has serotogenic properties and can exacerbate OR cause Serotonin Syndrome

Question 10

Why is Fentanyl contraindicated in late second stage labour?

Answer 10

• Fentanyl can cross the palcental barrier and lead to the baby being born apnoeic and narced