Description and indication for use
Fentanyl is a synthetic opioid analgesic
used for pain relief, sedation and to enhance anaesthetic agents.
Fentanyl has a quicker onset but a shorter
duration of action than Morphine and is less likely to cause hypotension.
Dose
IV:
5 micrograms/kg/dose slowly as a premed to intubation.
IV infusion:
1 to 5 micrograms/kg/hour to monitored ventilated patient.
(Note:
never use in an unventilated patient, except as a premed prior to intubation).
Reconstitution/Dilution
Ampoule = 100 micrograms in 2 mL.
IV 1:
For Intubation pre-med dose please see neat
dosing guidelines in Medicines for
Intubation and Resuscitation Quick Reference Guide page 121 [Appendix C].
IV 2: Stat Dose (Ventilated patient only)
Withdraw 0.2 mL of 50 micrograms/mL
solution and add to 0.8 mL of water for injection in a second 1 mL syringe = 10 micrograms/mL.
Discard excess volume to obtain ordered
dose or withdraw dose using another 1 mL syringe.
IV Infusion:
Dilution as above may be required.
Withdraw required dose and make up to
ordered volume of infusion solution.
|
Drug
|
How
to make up
|
Dose
equivalent
|
Dose
range
|
|
Fentanyl
|
100 micrograms/kg in 50 mL Glucose 10%
|
1 mL/hr
=
2 micrograms/kg/hr
|
1-5 micrograms/kg/hr
|
Route and method of administration
IV bolus:
Administer ordered dose slowly over 10
minutes.
IV infusion:
Infuse via syringe pump.
Side effects
Bradycardia and chest wall rigidity with
rapid infusion.
Hypotension.
Apnoea, respiratory depression (naloxone
should be available for reversal).
Tachyphylaxis with prolonged use.
Muscular rigidity.
Special precautions
Caution in patients with liver or kidney dysfunction.
Contraindications
Hypotension.
Compatible Solutions
Glucose 5%.
Sodium Chloride 0.9%.
Incompatibilities
Fentanyl must not be mixed together with the
following: Pentobarbital, Thiopental.
Compatibility information is limited.
Administer alone or contact Pharmacy if
further information is required.
Drug interactions
|
CNS depressant drugs such as barbiturates and
narcotic analgesics.
|
Will have enhanced effect when given with Fentanyl. Dosage may need to be reduced.
|
Nursing responsibilities
Monitor vital signs including BP.
Apply transcutaneous CO2 monitor (if requested by
Medical Staff).
Apply oximeter to monitor SaO2.
Change syringe every 24 hours.
Naloxone should be available for reversal.