FENTANYL CITRATE (Sublimaze)

Question 1

FENTANYL CITRATE (Sublimaze)

CLASS/ACTION:

Answer 1

CLASS/ACTION:

Opioid Analgesic

• Centrally acting opiate analgesic effective for acute pain.
• For cardiac patients: fentanyl reduces the pain of ischemia and reduces anxiety, reducing oxygen demands on the heart, improving perfusion.

Question 2

FENTANYL CITRATE (Sublimaze)

INDICATIONS:

Answer 2

INDICATIONS:

• Chest pain of suspected ischemic origin.
• Management of acute pain according to ALS Treatment Protocols.

Question 3

FENTANYL CITRATE (Sublimaze)

CONTRAINDICATIONS:

Answer 3

CONTRAINDICATIONS:

• Hypersensitivity or prior allergic reaction
• Respiratory Insufficiency
• Asthma or exacerbated COPD
• Head injury
• Hypotension
• Decreased LOC

Question 4

FENTANYL CITRATE (Sublimaze)

POTENTIAL SIDE EFFECTS:

Answer 4

POTENTIAL SIDE EFFECTS:

• Respiratory depression
• Hypotension
• Decreased LOC
• Nausea and vomiting
• Bradycardia
• Muscle rigidity (rare)

Question 5

FENTANYL CITRATE (Sublimaze)

ADULT DOSE/ROUTE:

Answer 5

ADULT DOSE/ROUTE:

 50 mcg IV/IO slow IV push (over 1 minute). May repeat every 5 minutes if SBP > 90 mm Hg.

The maximum dose is 200 mcg without base contact.

 If no IV/IO, 100 mcg IN or IM (IN preferred). May repeat every 10 minutes if SBP > 90 mm Hg.

The maximum dose is 200 mcg without base contact.

Question 6

FENTANYL CITRATE (Sublimaze)

PEDIATRIC DOSE/ROUTE:

Answer 6

PEDIATRIC DOSE/ROUTE:

 If IV/IO, 1 mcg/kg/dose IV/IO up to 50mcg slow IV push (over 1 minute). Subsequent dose up to 25 mcg may be repeated every 10 minutes up to the maximum dose of 100 mcg without Base Hospital contact.

 If no IV/IO, 2 mcg/kg/dose IN or IM (IN preferred) up to 50 mcg. Subsequent dose up to 25 mcg may be repeated every 10 minutes up to the maximum dose of 100 mcg without Base Hospital contact.

Question 7

FENTANYL CITRATE (Sublimaze)

NOTES:

Answer 7

NOTES:

• Rapid infusions of Fentanyl have been associated with chest wall rigidity and respiratory depression, particularly in pediatrics. Administer doses over 1-2 min to prevent occurrence.
• Fentanyl is 100x stronger than Morphine and is dosed in micrograms. It is faster acting than Morphine (peak effect 5-10 minutes) and has a shorter duration of effect (approximately 30 minutes). 100 mcg of Fentanyl is approximately equivalent to 10 mg of Morphine.
• Fentanyl can cause depressed respiratory status. Be prepared to assist ventilations in patients receiving Fentanyl.
• Respiratory depression from Fentanyl can be reversed with Naloxone.
• Fentanyl’s effects can be potentiated by Midazolam. Contact the Base Hospital Physician before administering both Fentanyl and Midazolam.
• Contact the Base Hospital Physician if higher doses of Fentanyl are required for adequate pain control.