Fentanyl

Question 1

What is the Pharmacology of Fentanyl

Answer 1

Fentanyl is a synthetic opioid analgesic.

Actions (DR-DD)

• CNS Depression
• Respiratory Depression
• Dependence
• Decrease conduction velocity through the AV node (Cardiovascular Effect).

Question 2

What is the Presentation of Fentanyl and How is it Metabolized.

Answer 2

Presentation

• 250mcg in 1ml (IN presentation)
• 100mcg in 2ml (IV Presentation).

Metabolized by the Liver and Excreted by the kidneys.

Question 3

What are the Indications and Contraindications of Fentanyl

Answer 3

Indications

• CPR Interfering patient
• Facilitate and Maintain Sedation.
• Sedation for Transthorasic Pacing
• Sedation for Sync Cardioversion
• Analgesia
  
  • Hx of hypersensitivity to Morphine
  • Known Renal Impairment or failure.
  • Short Duration of Action Desirable
  • Hypotension
  • Nausea/ Vomiting
  • Severe Headache

Contraindications

• Late Second Stage Labour
• Hypersensitivity to Fentanyl

Question 4

What are the Side Effects and Precautions of Fentanyl

Side Effects (RRAB)
Precautions (PRICKER)

Answer 4

Side Effects (RRAB)

• Respiratory Depression
• Apnoea
• Rigidity of the diaphragm & intercostal muscles.
• Bradycardia

Precautions (PRICKER)

• Patients on MAO Inhibitors.
• Respiratory Depression
• Rhinitis or facial Trauma.
• Impaired hepatic Function
• Current Asthma
• Known Addition to opioids.
• Elderly and Frail.

Question 5

Route of Administration and Special Notes.

Answer 5

Route of Administration

• IV
• IN

Special notes.

• Respiratory Depression can be reversed with Naloxone.
• 100mcg of Fentanyl is the equivalent to 10mg of morphine.

IV Effects
- Onset: Immediate 
- Peak: < 5 Minutes
- Duration: 30 - 60 Minutes
IN Effects
- Peak 2 Minutes