FENTANYL

Question 0

PHARMACOLOGY OF FENTANYL

Answer 0

A synthetic opioid analgesic

Question 1

PRESENTATION OF FENTANYL

Answer 1

100 mcg in 2 mL glass ampoule

600 mcg in 2 mL glass vial ( IN use only )

Question 2

ACTIONS OF FENTANYL

Answer 2

CNS Effects:
1. Depression- leading to analgesia
2. Respiratory depression - leading to apnoea
3. Dependence (addiction)
CARDIOVASCULAR EFFECTS:
1. Decreases conduction velocity through the AV node

Question 3

PRIMARY EMERGENCY INDICATIONS OF FENTANYL

List all 4

Answer 3

Pneumonic SADS

1. Sedation to facilitate inubation
2. Analgesia - IV/IN
3. Drug facilitated intubation
4. Sedation to maintain intubation

Question 4

CONTRAINDICATIONS FOR FENTANYL

Answer 4

1. Known hypersensitivity

2. IV Amiodarone (MICA)

Question 5

PRECAUTIONS FOR FENTANYL

Answer 5

1. Elderly Pts
2. Impaired renal / hepatic function (drug is metabolised by liver excreted by kidneys)
3. Respiratory depression, e.g. COPD
4. Current asthma
5. Pts on monoamine oxidase inhibitors
6. Known addiction to opiods
7. Rhinitis, rhinorrhea or facial trauma (IN route)
8. Oral Amiodarone

Question 6

ROUTE OF ADMINISTRATION OF FENTANYL

Answer 6

IV

IN

Question 7

SIDE EFFECTS OF FENTANYL

Answer 7

Respiratory depression
Apnoea
Rigidity of the diaphragm and intercostal muscles
Bradycardia

Question 8

ONSETS & DURATIONS OF FENTANYL

Answer 8

IV EFFECTS:

Onset: Immediate
Peak: <5 min
Duration: 30-60 min

IN EFFECTS
Peak: 2 min

*Special note; Respiratory depression can be reversed with Naloxone

Question 9

ADULT DOSE FENTANYL

Answer 9

IV
25 - 50 mcg @ 5/60 (Max 200 mcg)

IN
Pt 60 kg 200mcg
Repeat @ 5/60 up to 50 mcg (Max 400mcg)

Pt >60 yo &/or <60kg 100mcg
Repeat @ 5/60 up to 50 mcg (Max 200mcg)

Question 10

FENTANYL PAEDIATRIC DOSE

Answer 10

2 mcg/kg
Repeat @5/60 up to 1mcg/kg (Max 4mcg/kg)

*Note if Pt 25kg prepare from 600 mcg in 2mL