Fentanyl

Question 1

Presentation

Answer 1

100mcg in 2mL glass ampoule

OR

250mcg in a 1mL glass ampoule or cartridge (IN use only)

Question 2

Contraindicatoins

Answer 2

1. History of hypersensitivity

2. Late second stage labour

Question 3

Precautions

Answer 3

Elderly/frail patients

Impared hepatic function

Respiratory depression e.g. COPD

Current asthma

Known addiction to opioids

Rhinitis, rhinorrhea or facial trauma (IN route)

Question 4

Route of administration

Answer 4

IV, IV infusion, IN

Question 5

IV effects

Answer 5

Onset: Immediate
Peak: < 5 minutes
Duration: 30-60 minutes

Question 6

IN effects

Answer 6

Peak: 2 minutes

Question 7

Special notes

Answer 7

100mcg equivalent in analgesic activity to 10mg Morphine

Schedule 8 drug

Question 8

Primary indications

Answer 8

1. sedation to facilitate intubation (RSI modified or pediatric IFS)
2. Sedation to maintain intubation
3. Sedation to facilitate transthoracic pacing
4. Sedation to facilitate synchronized cardioversion
5. CPR inferring patient - ALS
6. Analgesia - IV/IN

• history of hypersensitivity or allergy to morphine
• known renal imparment/failure
• Short duration of action desirable
• Hypotension
• Nausea and/or vomiting
• severe headache

Question 9

Dosage - IV

Answer 9

Upto 50mcg at 5 minute intervals
ALS consult after 200mcg
NO MAX DOSE

Solution is 8ml of normal saline with 2ml (100mcg) fentanyl

Question 10

Dosage IN

Answer 10

200mcg
repeat up to 50mcg at 5 minute intervals if required
MAX dose - 400 mcg IN

OR

100mcg (<60kg/frail/elderly)
-Repeat up to 50mcg at 5 minute intervals if required
MAX dose 200mcg IN

Question 11

Dosage IM

Answer 11

100mcg
Repeat 50mcg after 15 minutes if required, ONCE only

OR

1mcg/kg (,60kg/frail/elderly)
NO REPEAT DOSE