fentanyl

Question 1

preparation

Answer 1

100mcg/2ml

Question 2

what Is it

Answer 2

opioid analgesic

Question 3

mechanism

Answer 3

binds to opiate receptors (stimulates them) causing analgesia
( fent/morph binds to opioid receptor stimulating G protein, G protein flicks a switch, to stop calcium going into the cell stopping it from becoming positive, thus inhibiting from sending signals, G protein opens potassium channels, letting positive change out of the cell, further inhibiting signal)

Question 4

indications

Answer 4

Moderate to severe pain.
Cardiogenic pulmonary oedema with severe anxiety.
Rapid sequence intubation.
Sedation post intubation.
Control of pain, agitation, or shortness of breath during end of life car

Question 5

contraindications

Answer 5

allergy

Question 6

cautions

Answer 6

1.Altered level of consciousness. Fentanyl may further reduce the level of consciousness.

2.Aged less than one year. (Children under the age of one year are at increased risk of respiratory depression following opiate administration)

3.Respiratory depression or at high risk of respiratory depression. For example, severe COPD, morbid obesity or on home BiPAP. (Such patients may develop respiratory depression following opiate administration because it inhibits the neutrons from firing up the spinal cord into the medulla)

4. Labour. (Opiates cross the placenta and may cause drowsiness and/or respiratory depression in the baby, particularly when administered within an hour or two of birth. Discuss administration with the lead maternity carer if possible. Following birth, close observation of the baby is required and personnel must be prepared to treat respiratory depression)

5.Concurrent administration of other opiates, ketamine or midazolam. (This will increase and prolong the effects)

6.Aged greater than or equal to 75 years, particularly if frail.( The effects of fentanyl will be increased and prolonged in this cohort)

7.Signs of shock. Fentanyl may make shock worse

Question 7

pregnancy??

Answer 7

if required

Question 8

onset

Answer 8

IV: 2-5 minutes. The maximal analgesic and respiratory depressant effects may not occur until 10-15 minutes and this may be longer in the elderly.
IN: 5-10 minutes.
IM/SC: 5-10 minutes.

Question 9

duration

Answer 9

30-60 minutes.The effect on respiration may last for several hours.

Question 10

IV dosage

Answer 10

IV for analgesia:
10-50 mcg every five minutes for an adult, as required. Use a dose at the lower end of the range if the patient is frail or has signs of shock.

Question 11

IM doseage

Answer 11

50-100 mcg IM/SC.
Subsequent doses may be administered every 20 minutes up to a total of three doses.
Halve all doses if the patient is frail or has signs of shock

Question 12

adverse effects

Answer 12

Respiratory depression.
Bradycardia.
Hypotension.
Sedation.
Nausea and vomiting.
Itch.
Euphoria.

Question 13

common interactions

Answer 13

The effects will be increased in the presence of other opiates and sedatives, for example, benzodiazepines or alcohol.

Question 14

10kg/ 1 y/o dose

Answer 14

2-10mcg