Paramedic Drug Facts: Fentanyl

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