Fentanyl Citrate (Sublimaze)

Question 1

Fentanyl Classification

Answer 1

Narcotic analgesic

Question 2

Fentanyl Mechanism of Action

Answer 2

Opiate R agonist -> hyperpolarization of interneurons and decreased release of neurotransmitters responsible for the transmission of pain impulses to the thalamus and cerebral cortex.

Question 3

Fentanyl Pharmacokinetics

Answer 3

Onset: Immediate
Peak: 3-5m IV
Duration: 30-60m
Half Life: 6-8h

Question 4

Fentanyl Indications

Answer 4

• Severe pain

- Adjunct for RSI

Question 5

Fentanyl Contratindications

Answer 5

• Respiratory depression or insufficiency when considering for pain management
• Uncorrected hypotension
• Known hypersensitivity

Question 6

Fentanyl Side Effects/Adverse Reactions

Answer 6

Bradycardia, respiratory depression, apnea, chest wall rigidity

Question 7

Fentanyl Dose

Answer 7

Adult:
1μg/kg slow IV, IO, IN; max single dose 100μg, repeat after 10 min
Adult >65y/o: 0.5μg/kg slow IV, IO, IN; max single dose 50μg, repeat in 5 min
Pedi:
1-2μg/kg slow IV, IO, IN

Question 8

Fentanyl Precautions

Answer 8

Caution in patients with kidney and liver dysfunction

Question 9

Fentanyl Drug Interactions

Answer 9

• Additive effects with CNS depressants

- Should not be given with patients using MAOI in the last 14 days - may cause Serotonin Syndrome