Fentanyl

Question 1

What type of medication is Fentanyl?

Answer 1

A synthetic opioid analgesic.

Question 2

What is the pharmacology and metabolism of Fentanyl?

Answer 2

• Fentanyl binds to (agonises) opioid receptors with a particular affinity for mu opioid receptors. The receptors become hyperpolarised, inhibiting the nerve activity.
• Fentanyl is metabolised by the hepatic system (liver) and excreted by the renal system.

Question 3

What is Fentanyl used for?

Answer 3

Pain management

Question 4

What are the most common adverse effects of Fentanyl?

Answer 4

• Respiratory depression
• Bradycardia
• Hypotension
• Nausea & Vomiting

Question 5

What are the contraindications of Fentanyl?

Answer 5

• Altered LOC (V, P or U)
• Epistaxis or occluded nasal passages
• Patients <1yo
• Previous or known allergy or adverse reaction
• Pregnant women > 20 weeks gestation in labour

Question 6

What preparation of Fentanyl is available for use?

Answer 6

Preparation: 100mcg/2ml ampoule

Question 7

What is the onset, duration, and half-life of Fentanyl?

Answer 7

• Onset: < 3 minutes
• Duration: 30 - 60 minutes
• Half-Life: 2 - 3 hours

Question 8

How is Fentanyl prepared for the different administrations?

Answer 8

• IV: 2mL (100mcg) Fentanyl diluted with 8mL saline to form 100mcg/10mL solution.
• SC/IM: Undiluted bolus (Note: this MOA is not available for paediatrics)
• IN: Draw up required volume undiluted (PLUS AND EXTRA 0.5mL FOR THE FIRST DOSE ONLY - to account for the dead space in the MAD)