Induction Meds: Opioids Agonist - Fentanyl Flashcards
How potent is fentanyl?
- 75 - 125 x Morphine.
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What is the blood-brain equilibration of fentanyl?
What does this mean?
- 6.4 minutes
- Potent with rapid onset and ↑ lipid solubility.
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What percent of fentanyl is subject to lung first-pass effect?
What does this mean?
- 75%
- Drug is taken up into lung tissue and possibly subjected to breakdown via pulmonary esterases.
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Where is fentanyl metabolized?
What is its principal metabolite?
- Liver via CYP3A
- Norfentanyl is the principal metabolite
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How does fentanyl dosing change for the elderly or liver patients?
No change in elderly or cirrhotic patients.
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Describe what the graph below is showing.
Fentanyl has the greatest context-sensitive half-time of any of the Fentanyl derivatives.
d/t saturation of inactive tissue
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What is the analgesia dosage of Fentanyl?
1 - 2 μg/kg IV
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1mg of PO Fentanyl = ____ mg of IV Morphine
5
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What is the intrathecal dosage of Fentanyl?
25 mcg
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What is the adult oral dose of Fentanyl?
Pediatric?
- Adult: 5 - 20 mcg/kg
- Peds: 15 - 20 mcg/kg
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What is the transdermal dose of Fentanyl?
75 - 100 μg (18 hours steady state)
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What cardiovascular side effects should be known about Fentanyl?
- no histamine release
- depress carotid sinus baroreceptor reflex
- no significant bradycardia
- ↓BP & ↓CO
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What organs are reservoirs and affect the drug’s pharmacokinetics’ dispositional phase?
Lungs
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What is removal of endogenous compounds form the pulmonary arterial blood?
Pulmonary Uptake/Extraction
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What is the term for drug gets retained/accumulated and removed/cleared/metabolized at a specific location in the body that result in a reduced concentration of the active drug upon reaching its site of action?
Lung First-Pass
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