Fentanyl Flashcards
What is fentanyl?
Fentanyl (100 microg / 2mL vial) is a synthetic narcotic analgesic that acts on the central nervous system by binding with the opioid receptors.
Hepatic metabolism & renal excretion
What is the onset, duration & half-life of fentanyl?
Onset <3 min
Duration 30-60 min
Half-life 2-3 hours
What are the indications for fentanyl?
- Significant pain
- Sedation
- Autonomic dysreflexia (with SBP >160 mmHg)
Note: morphine is the preferred narcotic agent except under the following circumstances:
- allergy/ADR to morphine
- haemodynamic instability
- known/suspected kidney disease
- when NAS narcotic administration is the preferred treatment
- suspected ACS
Contraindications for fentanyl?
- Allergy / ADR
Precautions for fentanyl?
- Hypotension
- Respiratory tract burns
- Respiratory depression and/or failure
- Known addiction to narcotics
- Current MAOI therapy
Side effects of fentanyl?
- Bradycardia
- Drowsiness
- Hypotension
- Nausea & vomiting
- Pinpoint pupils
- Respiratory depression
- Muscular rigidity (particularly muscles of respiration)
What is the fentanyl dose for an adult?
<70 years - 25-100 microg NAS
Repeated at up to 100 microg every 10 min
Total max dose 200 microg
<70 years - 25-100 microg IM
Repeated at up to 50 microg every 10 min
Total max dose 200 microg
<70 years - 25-50 microg IV
Repeated at up to 50 microg every 5 min
Total max dose 200 microg
> 70 years/cachectic or frail - 25-50 microg NAS
Repeated at up to 50 microg every 10 min
Total max dose 100 microg
> 70 years/cachectic or frail - 25-50 microg IM
Repeated at up to 50 microg every 10 min
Total max dose 100 microg
> 70 years/cachectic or frail - 25 microg IV
Repeated at up to 25 microg every 5 min
Total max dose 100 microg
What is the fentanyl dose for a paediatric?
Under 1 year (QAS clinical consult in all situations)
NAS
>1 year - 1.5 microg/kg
Repeated once at 1 microg/kg at 10 minutes
IM
>1 year - 1-2 microg/kg
Single max dose 50 microg
Total max dose 2 microg/kg
