Fentanyl Flashcards
Pharmacology and presentation of Fentanyl?
100mcg in 2ml
Opiate analgesic,that binds and stimulates opiate receptors in the brain and spinal cord causing analgesia
Indicators of Fentanyl?
- Moderate to severe pain.
- Cardiogenic pulmonary oedema with severe anxiety.
- RSI
- Sedation post intubation.
- Symptom control during end of life care.
Contraindications of Fentanyl?
- Known severe allergy.
- Unable to obey commands (exceptions: administration for RSI, end of life care and post intubation).
- Respiratory depression.
Cautions of Fentanyl?
3x age, 3 x down
- Aged less than one year.
- Elderly and/or frail.
- Labour.
- At high risk of respiratory depression. For example, severe COPD, morbid obesity or on home BiPAP.
- Concurrent administration of other opiates, ketamine or midazolam.
- Signs of shock.
Side Effects of Fentanyl?
3x head tap, 3x chest tap, 1x arm scratch
HEN RIBS
- Euphoria.
- Sedation.
- Nausea and vomiting.
- Respiratory depression.
- Bradycardia.
- Hypotension.
- Itch.
Dosing Regimes of Fentanyl?
Fentanyl IV Adult
- 10-50mcg IV, every 5mins prn for pain relief
- 10-20mcg IV doses every 5mins prn for severe anxiety in CPO
Fentanyl IM Adult
- 50-100mcg IM or SC, if IV can’t be obtained and IN inappropriate, repeat once after 20mins
Fentanyl IN Adult >80kgs
- 200mcg initially, repeats of up to 100mcg may be given 10minutely prn, halve the doses if PT is frail or physiologically unstable
Fentanyl IN Adult < or equal to 80kgs
- 100mcg initially, repeats of up to 50mcg may be given 10minutely prn, halve the doses if PT is frail or physiologically unstable
Fentanyl IV Paediatrics
- 5kg = 1-5mcg
- 10kg = 2-10mcg
- 20kg = 5-20mcg
- 30kg = 10-30mcg
- 40kg = 10-40mcg
Fentanyl IM Paediatrics
- 1mcg per kg, repeat once after 20mins
Fentanyl IN Paediatrics
- 2mcg per kg initially, 1mcg per kg repeats 10 minutely prn
Administration in Peadiatrics 20kg or less
- Draw up 100mcg:2ml, with 5% Glucose to make 100mcg:100ml
Onset and duration of Fentanyl?
Onset:
- 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: 5-10 minutes.
Duration
- 30-60minutes