Fentanyl
Trade Names: Alfentanil, Sufentanil, Sublimaze
Class: Opioid analgesic
Pharmacology:
Onset: immediate (IV)
Duration: 30-60 min
Combines with receptor sites in the brain to produce potent analgesic effects
Indications: Pain control, Sedation for invasive airway procedures
Contraindications:
Respiratory depression
Hypotension
Head injury
Cardiac Dysrhythmias
Myasthenia gravis
Hypersensitivity to opiates
Cautions:
Effects may be increased if given with with other central nervous system depressants or skeletal muscle relaxants
Dosage:
- Adult: 0.05-0.1 mg IV over 1-2 min every 1-2 hr as needed
- Pediatric: 1-2 mcg/kg Rarely used in prehospital setting
- Rapid sequence intubation: 2-5 mcg/kg IV/IO
Side Effects:
Respiratory depression
Bradycardia
Hypotension/hypertension
Nausea and vomiting
Chest wall muscle rigidity
Special Considerations:
Pregnancy Safety: Category C
Schedule II drug with potential for abuse
Use with caution in elderly patients and in those with severe respiratory disorders, seizure disorders, cardiac disorders, or pregnancy
Naloxone or nalmefene should be available to reverse respiratory depression