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AV Pharmacology > Fentanyl > Flashcards

Fentanyl Flashcards

1
Q

Presentation

A

100 mcg in 2 mL glass ampoule

250 mcg in 1 mL glass ampoule or cartridge for IN use

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2
Q

Pharmacology - CNS effects

A

Depression - leading to analgesia
Respiratory depression - leading to apnoea
Dependence (addiction)

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3
Q

Pharmacology - Cardiovascular effects

A

Decreases conduction velocity through the AV node

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4
Q

Metabolism

A 
Metabolised = liver
Excreted = kidneys
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5
Q

Indications

A

Sedation to facilitate intubation
Sedation to maintain intubation
Sedation to facilitate trans thoracic pacing
Sedation to facilitate synchronised cardioversion
CPR interfering patient - ALS
Analgesia - IV/IN

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6
Q

Specific Fentanyl Analgesia Indications

A 
History of hypersensitivity or allergy to morphine
Known renal impairment/failure
Short duration of action desirable
Hypotension
Nausea/vomiting
Severe headache
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7
Q

Contras

A

History of hypersensitivity

Late second stage labour

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8
Q

Precautions

A 
Elderly/frail pts
Impaired hepatic function
Respiratory depression eg: COPD
Current asthma
Pts on monoamine oxidase inhibitors
Known addiction to opioids
Rhinitis, rhinorrhea or facial trauma (IN route)
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9
Q

Route of administration

A

IV
IN
IV infusion

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10
Q

Side effects

A

Respiratory depression
Apnoea
Rigidity of the diaphragm and intercostal muscles
Bradycardia

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11
Q

IV effects

A 
Onset = Immediate
Peak = < 5 mins
Duration = 30-60 mins
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12
Q

IN effects

A

Peak = 2 mins

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13
Q

Moderate Pain - Adult IV

A

up to 50 mcg IV
Repeat up to 50 mcg IV @ 5 min intervals
Consult after 200 mcg IV

Consider Paracetamol in combination

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14
Q

Moderate Pain - Adult IN

A

200 mcg IN
Repeat up to 50 mcg IN @ 5 min intervals
Max 400 mcg IN

Consider Paracetamol in combination

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15
Q

Moderate Pain - < 60 kg /Frail/elderly

A

100 mcg IN
Repeat up to 50 mcg IN @ 5 min intervals
Max 200 mcg IN

Consider Paracetamol in combination

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16
Q

Severe Headache

A

Fentanyl should only be used to treat severe headache where other measures have failed and where transport to treating facility is prolonged

IV Adult up to 50 mcg IV, repeat @ 5 min intervals, consult after 200 mcg IV
IN Adult 200 mcg IN, repeat up to 50 mcg @ 5 min intervals, max 400 mcg IN
IN Frail Adult 100 mcg IN, repeat up to 50 mcg @ 5 min intervals, max 200 mcg IN

Aim to reduce pain to < 7.

17
Q

Paediatric Moderate Pain

A 
Small child (10-17 kg) 25 mcg IN
Medium child (18-39 kg) 25-50 mcg IN
Repeat initial dose @ 5-10 mins 
Consult after 3 doses

Consult with RCH for doses in children < 10 kg

Consider paracetamol in combination

18
Q

Preparation for IV Analgesia administration

A

100 mcg in 2 mL
Dilute with 8 mL Normal Saline in a 10 mL syringe
= 10 mcg in 1 mL

AV Pharmacology (23 decks)

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