Fentanyl Flashcards
Presentation
100 mcg in 2 mL glass ampoule
250 mcg in 1 mL glass ampoule or cartridge for IN use
Pharmacology - CNS effects
Depression - leading to analgesia
Respiratory depression - leading to apnoea
Dependence (addiction)
Pharmacology - Cardiovascular effects
Decreases conduction velocity through the AV node
Metabolism
Metabolised = liver Excreted = kidneys
Indications
Sedation to facilitate intubation
Sedation to maintain intubation
Sedation to facilitate trans thoracic pacing
Sedation to facilitate synchronised cardioversion
CPR interfering patient - ALS
Analgesia - IV/IN
Specific Fentanyl Analgesia Indications
History of hypersensitivity or allergy to morphine Known renal impairment/failure Short duration of action desirable Hypotension Nausea/vomiting Severe headache
Contras
History of hypersensitivity
Late second stage labour
Precautions
Elderly/frail pts Impaired hepatic function Respiratory depression eg: COPD Current asthma Pts on monoamine oxidase inhibitors Known addiction to opioids Rhinitis, rhinorrhea or facial trauma (IN route)
Route of administration
IV
IN
IV infusion
Side effects
Respiratory depression
Apnoea
Rigidity of the diaphragm and intercostal muscles
Bradycardia
IV effects
Onset = Immediate Peak = < 5 mins Duration = 30-60 mins
IN effects
Peak = 2 mins
Moderate Pain - Adult IV
up to 50 mcg IV
Repeat up to 50 mcg IV @ 5 min intervals
Consult after 200 mcg IV
Consider Paracetamol in combination
Moderate Pain - Adult IN
200 mcg IN
Repeat up to 50 mcg IN @ 5 min intervals
Max 400 mcg IN
Consider Paracetamol in combination
Moderate Pain - < 60 kg /Frail/elderly
100 mcg IN
Repeat up to 50 mcg IN @ 5 min intervals
Max 200 mcg IN
Consider Paracetamol in combination