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Fentanyl

Presentation
  • 100 mcg in 2 mL glass ampoule
  • 250 mcg in 1 mL glass ampoule or cartridge (IN use only)
Pharmacology

A synthetic opioid analgesic

Actions:

CNS effects:

  • Depression – leading to analgesia
  • Respiratory depression – leading to apnoea
  • Dependence (addiction)

Cardiovascular effects:

  • Decreases conduction velocity through the A-V node
Metabolism

By the liver; excreted by the kidneys

  1. Sedation to facilitate intubation (RSI – modified or Paediatric IFS)
  2. Sedation to maintain intubation
  3. Sedation to facilitate transthoracic pacing
  4. Sedation to facilitate synchronised cardioversion
  5. CPR interfering patient – ALS
  6. Analgesia – IV/IN
    • History of hypersensitivity or allergy to morphine
    • Known renal impairment / failure
    • Short duration of action desirable
    • Hypotension
    • Nausea and/or vomiting
    • Severe headache
  1. History of hypersensitivity
  2. Late second stage of labour
  1. Elderly/frail patients
  2. Impaired hepatic function
  3. Respiratory depression, e.g. COPD
  4. Current asthma
  5. Patients on monoamine oxidase inhibitors
  6. Known addiction to opioids
  7. Rhinitis, rhinorrhea or facial trauma (IN route)
Route of administration
  • IV
  • IV infusion
  • IN
  • SC
  • Respiratory depression
  • Apnoea
  • Rigidity of the diaphragm and intercostal muscles
  • Bradycardia
Special Notes

Fentanyl is a Schedule 8 drug under the Poisons Act and its use must be carefully controlled with accountability and responsibility

Respiratory depression can be reversed with Naloxone

100 mcg Fentanyl is equivalent in analgesic activity to 10 mg Morphine

IV Effects

Onset: Immediate
Peak: < 5 minutes
Duration: 30 – 60 minutes

IN Effects


Peak: 2 minutes

Quiz