Fentanyl/ Sublimaze/ Atiq

Question 1

Fentanyl Class

Answer 1

• Synthetic Opiate, Narcotic Analgesic
• Opiate
• Schedule II Controlled Substance

Question 2

Fentanyl Action

Answer 2

• Potent µ-opiate receptor agonist.
• Peripheral vasodilator
• Increases venous capacitance
• Decreases venous return
• Depresses the responsiveness of alpha-adrenergic receptors.
• decreases both preload and afterload
• Decrease myocardial oxygen demand.
• Metabolized in the liver, excreted by the kidneys, and stored in body fat.

Question 3

Fentanyl Indication

Answer 3

• Moderate to Severe Pain

* Adjunct for Intubation

Question 4

Fentanyl Contraindication

Answer 4

• Hypersensitivity
• Hypovolemia
• Hypotension (except as an adjunct in RSI)
• Hypersensitivity
• Head injury
• Myasthenia Gravis (causes severe muscle rigidity)
• Patients who have taken MAOI (Anti-depressants such as Nardil and Parnate) within 14 days. MAOIs may cause paradoxical excitation, and in some cases seizures, hyperthermia, hypertension, and death.

Question 5

Fentanyl Precaution

Answer 5

• Respiratory depression
• Severe heart disease
• Geriatrics
• Pregnancy (C) (increases to D if used for prolonged periods or high doses close to term)
• May worsen bradycardia or heart block in inferior MI (vagotonic effect)
• Liver Failure/Kidney failure (may prolonged duration)

Question 6

Fentanyl Dosage

Answer 6

Adults:
• IV/IO/IM/IN: 1 mcg/kg initial dose (max initial 100 mcg)
• Give SIVP over 2 min (w/ the exception of the IN route)
• May repeat every 10 min PRN. Max total dose 200 mcg.
Pediatrics (Greater than 2 years of age):
• IV/IO/IM/IN: 1-2 mcg/kg initial dose (Max initial 75 mcg)
• Give SIVP over 2 min (exception with IN route)
• May repeat q 10 min PRN. Max dose 150 mcg.

Question 7

Fentanyl Onset/ Duration

Answer 7

• Onset: IV/IN/IO: 1-3 min IM: 10-20 minutes
• Duration: 1-2 hours
• Peak effects in 30 minutes

Question 8

Fentanyl Side Effects

Answer 8

• Dizziness
• Altered L. O. C.
• Hallucinations
• Euphoria
• Mental impairment
• Hypotension
• Seizures (rare)
• Lightheadedness
• Bradycardia, Tachycardia
• N/V
• CNS Depression
• Respiratory Depression
• Muscle Rigidity

Question 9

Fentanyl Interactions

Answer 9

• CNS depressants may enhance effects (antihistamines,
antiemetics, sedatives, hypnotics, barbiturates, and alcohol.
• No not mix in line with heparin