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DRUG ICARDS

Fentanyl

QuestionAnswer
Mechanism of action Fentanyl is an opiate analgesic. It is an opiate agonist (or stimulator) that binds to opiate receptors in the brain and spinal cord causing analgesia.
Indications (2 paramedic) -Moderate to severe pain -Control of pain, agitation, or shortness of breath during end-of-life care
Contraindications- 1 Known severe allergy.
Cautions 7 -Altered level of consciousness. -Respiratory depression or at high risk of respiratory depression. -Aged less than one year. -Labour. -Shock -Concurrent administration of other opiates, ketamine -Age equal or greater 75 years
Dosage IV for analgesia:10-50 mcg every five minutes for an adult, as required. Use a dose at the lower end of the range if the patient is frail or has signs of shock. See the paediatric drug dose tables for a child.
IV for analgesia: 10-50 mcg every five minutes for an adult, as required. Use a dose at the lower end of the range if the patient is frail or has signs of shock.
IN for analgesia: children See the paediatric drug dose tables. Subsequent doses may be administered every 20 minutes up to a total of three doses. Halve all doses if the patient has signs of shock. Draw up in two syringes, prime MAD with 0.1ml
IM and SC for analgesia if IV access cannot be obtained: Adult: 50-100 mcg IM/SC. Subsequent doses may be administered every 20 minutes up to a total of three doses. Halve all doses if the patient is frail or has signs of shock. Children: See the paediatric drug dose tables for a child. Subsequent doses m
IV children Dilute 100 mcg to a total of 10 ml using 0.9% sodium chloride for an adult or a child whose weight has been rounded up to 30 kg or more. This final solution contains 10 mcg/ml. Dilute 100 mcg to a total of 100 ml for a child whose weight has been rounded
SC administration: Administer undiluted subcutaneously into the abdominal wall.
Common adverse effects -Respiratory depression -Bradycardia -Hypotension. -Sedation. -Nausea and vomiting. -Itch. -Euphoria.
Usual onset of effect IV 2-5 minutes. The maximal analgesic and respiratory depressant effects may not occur until 10-15 minutes and this may be longer in the elderly IN 5-10 minutes IM/SC: 5-10 minutes.
Usual duration of effect 30-60 minutes .The effect on respiration may last for several hours.
Usual preparation Ampoule containing 100 mcg in 2 ml.
Pharmacokinetics -Fentanyl is more lipophilic (fat soluble) than morphine and this is why fentanyl is well absorbed through the nasal mucosa. -Fentanyl may cause a small amount of histamine release this usually results in a small fall in BP -Metabolised in the liver
Common interactions The effects will be increased in the presence of other opiates and sedatives, for example, benzodiazepines or alcohol.
Created by: nicolaprice01
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