Fentanyl

Question 1

Fentanyl- Name

Answer 1

Sublimaze

Question 2

Fentanyl- Class

Answer 2

Narcotic Analgesic

Question 3

Fentanyl- MoA

Answer 3

Provides analgesia and sedation by acting on the opiate receptors in the brain, blocking sensation of pain.

Question 4

Fentanyl- Indication

Answer 4

sedation during rapid sequence intubation

moderate to severe pain

Question 5

Fentanyl- Contra

Answer 5

patients who have received MAO inhibitors in the last 14 days

myasthenia gravis

Question 6

Fentanyl- S/E

Answer 6

Cardiovascular: hypotension, bradycardia, circulatory depression, cardiac arrest

**CNS: **sedation, euphoria, dizziness, diaphoresis, seizures with high doses, delirium

Respiratory: respiratory depression or arrest, bronchoconstriction, laryngospasm

GI: nausea/vomiting, constipation

Question 7

Fentanyl- Routes

Answer 7

IV, IO, IM, TD (home medication patch)

Question 8

Fentanyl- A. Dose

Answer 8

25-100 mcg SLOW IV push (over 2-3 minutes)

Question 9

Fentanyl- P. Dose

Answer 9

2.0 mcg/kg SLOW IV push or IM

Question 10

Fentanyl- EXTRAS

Answer 10

Precautions: Use with caution in head injuries, suspected or known increased intracranial pressure; the elderly, debilitated or immuno-compromised patients; COPD or other respiratory problems and those with kidney or liver dysfunction.

Use caution in pregnancy and in children < 2 years old due to respiratory paralysis side effects.

Interactions: Alcohol and other CNS depressants potentiate effects of fentanyl; MAO inhibitors may precipitate hypertensive crisis.

Onset is immediate; peak effect in 3-5 min IV, 5-15 IM; duration is 30-60 minutes (or hours with transdermal patch).

Duration of respiratory depressant effects may be significantly longer than analgesic effects – always have oxygen immediately available and be prepared with intubation equipment and a narcotic antagonist (i.e. naloxone).