Fentanyl

Question 1

Fentanyl
drug Class

Answer 1

Narcotic Analgesic – Synthetic narcotic analgesic that acts on the central nervous system by binding to the opioid receptors.

Question 2

** Fentanyl**
Onset

Answer 2

IV/IO/IN (< 3 mins)

Question 3

** Fentanyl**
Duration

Answer 3

IV/IO/IN (30 – 60 mins)

Question 4

** Fentanyl**
Indications

Answer 4

• Moderate to severe pain

Question 5

** Fentanyl**
Contraindications

Answer 5

• Hypersensitivity to fentanyl
• Child <1 year of age (for IV / IO only)
• Occluded nasal passages or epistaxis (for IN only)

Question 6

Fentanyl
IV / IO
Preparation

Answer 6

Dilute 100 microg in 2 mL with 8 mL NaCl 0.9% to produce 10 microg/1mL.

Question 7

Fentanyl
IV / IO
Dose

Answer 7

Adult < 70 yrs
* Pre hospital loading dose - 1mcg/kg, slow push over 3 -5 mins (Max bolus 100mcg)
* Repeat at 25 mcg every 5 mins titrated to effect

Adult > 70 yrs
* Pre hospital loading dose - 0.5 mcg/kg, slow push over 3 -5 mins (Max bolus 50 mcg)
* Repeat at 25 mcg every 5 mins titrated to effect

Paediatric
* Pre hospital loading dose - 0.5 -1 mcg/kg, slow push over 3 -5 mins (Max bolus 25 mcg)
* Repeat at 1mcg/kg (max bolus 25 mcg) every 5 mins titrated to effect

Question 8

Fentanyl
INTRANASAL
Dose

Answer 8

Adult < 70
* initial dose- 3 x .2ml (180mcg)
* Repeated after 5 - 10 mins at 1 x 0.2ml (60mcg)
(subsequent IV dose 25 mcg every 5 mins titrated to effect)

Adult > 70 small, Frail
* initial dose- 2 x .15ml (90mcg)
* Repeated after 5 - 10 mins at 1 x 0.15ml (45mcg)

(subsequent IV dose 25 mcg every 5 mins titrated to effect)

Paediatric < 20kg
* initial dose- 1 x .05ml (15mcg)
* Repeated once only after 5 - 10 mins at 1 x 0.05ml (15mcg)

(subsequent IV dose 1mcg/kg (max bolus 25mcg) every 5 mins titrated to effect)

Paediatric 21- 30kg
* initial dose- 1 x .10ml (30mcg)
* Repeated once only after 5 - 10 mins at 1 x 0.10ml (30mcg)

(subsequent IV dose 1mcg/kg (max bolus 25mcg) every 5 mins titrated to effect)

Paediatric 31- 40kg
* initial dose- 1 x .15ml (45mcg)
* Repeated once only after 5 - 10 mins at 1 x 0.15ml (45mcg)

(subsequent IV dose 25 mcg every 5 mins titrated to effect)

Question 9

**Fentanyl **
Ramped patients

Answer 9

Maintenance doses only
(max bolus 25mcg)

Question 10

** Fentanyl**
Side Effects

Answer 10

• Drowsiness
• Nausea/vomiting
• Respiratory depression
• Bradycardia
• Hypotension (rare)