Fentanyl (Sublimaze)

Question 1

Class / Duration of Action

Answer 1

Narcotic Analgesic / Potent analgesic, sedative, euphoric

Question 2

Onset / Duration of Action

Answer 2

1. Onset IV/IO/IN: 1min / 30-60sec Duration

2. Onset IM: 7-8min / 1-2hrs Duration

Question 3

Indications

Answer 3

1. Severe Pain

2. RSI

Question 4

Contraindications

Answer 4

1. Known Hypersensitivity
2. Myasthenia Gravis
3. Monamine Oxidase Inhibitor (MAOI) Antidepressant use

Question 5

Precautions

Answer 5

1. Bradycardia
2. Respiratory Depression
3. Head Trauma with Increased ICP
4. Severe liver or renal insufficiencies

Question 6

Dosages / Administration

Answer 6

1. ADULTS:
   a. Pain Management: 25mcg - 100mcg increments IN/IM/IV/IO every 5-10min titrations to effect; Maximum Dose 300mcg if BP >90 Systolic. Refer to specific sections of the protocol for dosages specific to your pt’s presentation
   b. Post-RSI: 1mcg/kg IV/IO every 10min PRN
2. PEDS:
   a. Pain Management: 1-2mcg/kg IN/IM/IV/IO
   b. Post-RSI: 1mcg/kg IV/IO every 10min PRN

Question 7

Adverse Reactions

Answer 7

Hypotension, Bradycardia, CNS Depression, Nausea, Vomiting, Respiratory Depression, Chest Wall Rigidity