Fentanyl

Question 1

Fentanyl Class

Answer 1

Narcotic analgesic

Question 2

Fentanyl Description

Answer 2

Synthetic narcotic analgesic with a rapid onset and short duration of action. It has a half-life of 6.5 minutes when IN route is used.

Question 3

Fentanyl Presentation

Answer 3

100 micrograms in 2 mL ampoule. (0.1 mg in 2 mL)

Question 4

Fentanyl Administration

Answer 4

Intranasal (IN)

Intravenous (IV)

Question 5

Fentanyl Indications

Answer 5

Acute severe pain

Question 6

Fentanyl Contraindications

Answer 6

<1 year old
Known fentanyl hypersensitivity
ALoC
Bilateral occluded nasal passage
Nasal trauma
Epistaxis
Hypovolaemia.

Question 7

Fentanyl Dosage

Answer 7

Adult: 0.1mg (100mcg) IN
(Rpt x 1 at not < 10 mins if severe pain persists)
0.05mg (50mcg) IN

Paediatric: 0.0015 mg/Kg (1.5 mcg/Kg) IN.
Repeat by one after 10 minutes if severe pain persists.

Question 8

Fentanyl Pharmagology

Answer 8

Fentanyl provides some of the effects typical of other opioids through its agonism of the opioid receptors.
Its strong potency inrelation to that of morphine is largely due to its high lipophilicity.
Because of this, it can more easily penetrate the CNS.
Fentanyl binds to μ-opioid G-protein-coupled receptors, which inhibit pain neurotransmitter release by decreasing intracellular Ca2+ levels.

Question 9

Fentanyl Side Effects

Answer 9

Sedation
Nausea and Vomiting
Respiratory Depression

Question 10

Fentanyl Additional Info

Answer 10

Caution if patient has transdermal Fentanyl patch.
Include an additional 0.1 mL, to allow for dead space in MAD, in the calculated volume required.
Administer 50% volume in each nostril if more than 1 mL.
(Adults) In the absence of acquiring IV access, a second dose of IN Fentanyl may be administered