FENTANYL CITRATE (fen'ta-nil) Duragesic, Actiq Oralet, Sublimaze, Ionsys Classifications: analgesic; narcotic (opiate) agonist; Therapeutic: narcotic analgesic; opiate agonist Prototype: Morphine Pregnancy Category: C (B for fentanyl injection) Controlled Substance: Schedule II |
0.05 mg/mL injection; 100 mcg, 200 mcg, 300 mcg, 400 mcg lozenges; 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, 1600 mcg lozenges on a stick; 12 mcg/h, 25 mcg/h, 50 mcg/h, 75 mcg/h, 100 mcg/h transdermal patch
Synthetic, potent narcotic agonist analgesic with pharmacologic actions qualitatively similar to those of morphine, but action is more prompt and less prolonged. Principal actions: analgesia and sedation. Drug-induced alterations in respiratory rate and alveolar ventilation may persist beyond the analgesic effect.
Provides analgesia for moderate to severe pain as well as sedation.
Short-acting analgesic during operative and perioperative periods, as a narcotic analgesic supplement in general and regional anesthesia, and with droperidol or with diazepam to produce neuroleptanalgesia. Also given with oxygen and a skeletal muscle relaxant (neuroleptoanesthesia) to selected high-risk patients (e.g., those undergoing open heart surgery) when attenuation of the response to surgical stress without use of additional anesthesia agents is important.
Patients who have received MAO INHIBITORS within 14 d; substance abuse; myasthenia gravis; labor and delivery; pregnancy (category C, and category B for fentanyl injection).
Head injuries, increased intracranial pressure; older adults, debilitated, poor-risk patients; cardiac diseases, angina, hypotension, or cardiac arrhythmias; COPD, other respiratory problems; liver and kidney dysfunction; bradyarrhythmias; children.
Premedication Adult: IM 50100 mcg 3060 min before surgery PO Suck on 400 mcg lozenge until sedated Child: PO Suck on lozenge until sedated, 1025 kg, 200 mcg lozenge; 2535 kg, 300 mcg lozenge; 3540 kg, 400 mcg lozenge Adjunct for Regional Anesthesia Adult: IM/IV 50100 mcg General Anesthesia Adult: IV 220 mcg/kg, additional doses of 25100 mcg as required Child: IV 12 mcg/kg as needed Postoperative Pain Adult: IM/IV 50100 mcg q12h prn Child: IM 1.73.3 mcg/kg q12h prn Chronic Pain Adult: Transdermal Individualize and regularly reassess doses of transdermal fentanyl; for patient not already receiving an opioid, the initial dose is 25 mcg/h patch q3d; for patients already on opioids, see package insert for conversions Stick lozenge (Actiq) Place in mouth between cheek and lower gum and suck on lozenge; should be consumed over 15-min period |
Intravascular PREPARE: Direct: Give parenteral doses undiluted or diluted in 5 mL sterile water or NS. ADMINISTER: Direct: Infuse over 35 min. INCOMPATIBILITIES Solution/additive: Fluorouracil, lidocaine. Y-site: Azithromycin, phenytoin. |
Assessment & Drug Effects