Fentanyl citrate

[FEN-tah-nil] Pregnancy Category: C

Actiq, Fentanyl Oralet, Sublimaze [CII] [Rx]

Classification: Opioid analgesic, morphine type

See also Opioid Analgesics. Action/Kinetics: Similar to those of morphine and meperidine. IV. Onset: 7-8 min. Peak effect: Approximately 30 min. Duration: 1-2 hr. tVi: 1.5-6 hr. When the oral lozenge (transmucosal administration) is sucked, fentanyl citrate is absorbed through the mucosal tissues of the mouth and GI tract. Peak effect, transmucosal: 20-30 min. Actiq resembles a lollipop; sucking provides a rapid onset of action. Faster-acting and shorter duration than morphine or meperidine.

Uses: Parenteral: Preanesthetic medication, induction, and maintenance of anesthesia of short duration and immediate postoperative period. Supplement in general or regional anesthesia. Combined with droperidol for preanesthetic medication, induction of anesthesia, or as adjunct in maintenance of general or regional anesthesia. Combined with oxygen for anesthesia in high-risk clients undergoing open heart sur gery, orthopedic procedures, or complicated neurologic procedures.

Oral (transmucosal): Anesthetic premedication in children and adults in an operating room setting. To induce conscious sedation before diagnostic or medical procedures (use only in closely monitored situations due to the risk of hypoventilation). Ac-tiq is used for severe pain associated

■ with cancer treatment in those already using an opiate but experience breakthrough pain. Contraindications: The transmu-cosal form is contraindicated in children who weigh less than 15 kg, for the treatment of acute or chronic pain (safety for this use not established), and for doses in excess of 15 mcg/kg in children and in excess of 5 mcg/kg (maximum of 400 mcg) in adults. Use outside the hospital setting is contraindicated. Myasthenia gravis and other conditions in which muscle relaxants should not be used. Clients particularly sensitive to respiratory depression. Use during labor. Special Concerns: Safety and effectiveness have not been determined in children less than 2 years of age. Use with caution and at reduced dosage in poor-risk clients, children, the elderly, and when other CNS depressants are used. Use of the trans-mucosal form carries a risk of hypoventilation that may result in death. Additional Side Effects: Skeletal and thoracic muscle rigidity, especially after rapid IV administration. Bradycardia, seizures, diaphoresis. Additional Drug Interactions: T Risk of CV depression when high doses of fentanyl are combined with nitrous oxide or diazepam. How Supplied: Injection: 0.05 mg/mL; Lozenge: 100 mcg, 200 mcg


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