TB 171 - Fentanyl Citrate

Question 1

What is a synthetic opiate that has replaced morphine sulfate for the management of moderate to severe pain?

Answer 1

Fentanyl citrate

Question 2

Fentanyl is how many times more powerful that morphine sulfate and produces fewer side effects?

Answer 2

50-100 times

Question 3

Fentanyl has a faster onset than morphine sulfate as well as a shorter what, which improves a physicians ability to properly assess the patient?

Answer 3

Half life

Question 4

Fentanyl is intended to be used on patients that have what?

Answer 4

Burns
Isolated extremity injury and trauma
Medical complaints (non trauma abd pain)
Chest pain (cardiac)

Question 5

What are the contraindications of fentanyl?

Answer 5

Known hypersensitivity or allergy
Respiratory depression (less than 12 breaths/min)
Active labor

Question 6

Caution should be used when administering fentanyl on what patients?

Answer 6

Elderly
Systolic BP less than 100
ALOC
Onset acute headache
Respiratory failure (CHF, COPD, inhalation injury)
Suspected drug/alcohol intoxication

Question 7

How can fentanyl be administered into the body?

Answer 7

IV, IM, IN (intranasal), IO

Question 8

Fentanyl measurements are administered in what measurement?

Answer 8

Micrograms (mcg)

Question 9

How many mcg can be administered through slow IV/IO/IM/IN push and may repeat every 5 minutes prn for adults?

Answer 9

150 mcg

Question 10

What is the max dose that can be administered for adults prior to base contact?

Answer 10

150 mcg

Question 11

After base contact administration of fentanyl can be repeated every 5 minutes for adults with a total max dose of what?

Answer 11

250 mcg

Question 12

For elderly patients start with how much fentanyl?

Answer 12

25 mcg

Question 13

For pediatric multi system trauma and isolated head injury what is the dose for slow IV/IO and IN, which is 1 time only?

Answer 13

1 mcg/kg for IO/IV

1.5 mcg/kg for IN

Question 14

Base contact must be made for additional pain management in pediatrics or for initial orders if patient is not alert and oriented with a GCS of what?

Answer 14

15

Question 15

What is the max total dosages for a pediatric with multi-system trauma and for isolated head injury?

Answer 15

4 for multi-system trauma

2 for isolated head injury

Question 16

For pediatric isolated extremity injury how much fentanyl do they feel through IV or IM?

Answer 16

1 mcg/kg for IV

1.5 mcg/kg for IN

Question 17

For pediatric isolated extremity injury you may give how many doses after 5 minutes with a total of how many doses prior to base contact?

Answer 17

1 more dose after 5 minutes, 2 doses max prior to base contact

Question 18

After base contact for pediatrics have isolated extremity injury, what is the max dose of fentanyl they can receive?

Answer 18

4 doses

Question 19

Once fentanyl is administered you should monitor what is this may cause respiratory depression?

Answer 19

Respiratory status

Question 20

What can be used to reverse fentanyl?

Answer 20

Naloxone

Question 21

Rapid administration of fentanyl can cause what which is uncommon?

Answer 21

Chest wall rigidity

Question 22

What are the common side effects of fentanyl?

Answer 22

Nausea, vomiting, drowsiness, dry mouth, dizziness, difficulty urinating, constricted pupils