FENTANYL

“SUBLIMAZE”

1) Action

• Rapid, short acting narcotic analgesic

• Analgesic & sedative

• More potent & shorter acting than morphine

2) Mechanism

• Act on narcotic receptors in CNS

• Shares properties of naturally occurring enkephalins & endorphins

• Exert effect on CNS in 2 ways:

1) Reduce ability of patient to perceive sensation

2) Alter emotional reaction to sensation so that it is no longer perceived as pain

3) Indications

• Short duration analgesia during premedication, induction & maintenance of anaesthesia & in the immediate postoperative period

4) Effects on organs—side effects

• Respiratory depression

• Nausea & vomiting

• Cardiovascular depression

• Suppression of cough reflexes

5) Toxic effects/ precautions with administration

• Caution when given to patients on MAO inhibitors

6) Contraindications

• Head injuries [resp depression —> CO2 retention]

• Impaired respiratory or hepatic function

7) Reversal, antagonism or antidote

• Naloxone with respiratory support

8) Loading dose, maintenance dose, frequency & method of administration

• 500mcg/10 ml ampoules; 100mcg/2 ml

9) Drug’s metabolism—Drug’s excretion—Half life (pharmacokinetics)

• Duration of analgesic effect 30 - 60 minutes (IV)

• Onset of action is almost instant (IV)

• Elimination half life: 3 hr

• % plasma binding: 95%

• 100 mcg fentanyl @ 10 mg morphine