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Back to Narcotic Analgesics

Name: Fentanyl

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Pregnancy Category B

Drug classes
Narcotic agonist analgesic

Mechanism of action of Fentanyl
Acts at specific opioid receptors, causing analgesia, respiratory depression, physical depression, euphoria.

Indications of Fentanyl

  1. Analgesic action of short duration during anesthesia and in the immediate
    postoperative period
  2. Analgesic supplement in general or regional anesthesia
  3. Administration with a neuroleptic as an anesthetic premedication, for
    induction of anesthesia, and as an adjunct in maintenance of general and
    regional anesthesia
  4. For use as an anesthetic agent with oxygen in selected high-risk patients
  5. Transdermal system: management of chronic pain in patients requiring
    opioid analgesia

Contraindications of Fentanyl

  1. Contraindicated in the presence of hypersensitivity to narcotics,
    diarrhea caused by poisoning, acute bronchial asthma, upper airway
    obstruction, pregnancy.
  2. Use caution in the presence of bradycardia, history of seizures,
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Adverse effects of Fentanyl

  • CNS: Sedation, clamminess, sweating, headache, vertigo, floating feeling, dizziness, lethargy, confusion, lightheadedness, nervousness, unusual dreams, agitation, euphoria, hallucinations, delirium, insomnia, anxiety, fear, disorientation, impaired mental and physical performance, coma, mood changes, weakness, headache, tremor, convulsions
  • GI: Nausea, vomiting, dry mouth, anorexia, constipation, biliary tract spasm
  • CV: Palpitation, increase or decrease in blood pressure, circulatory depression, cardiac arrest, shock, tachycardia, bradycardia, arrhythmia, palpitations
  • Respiratory: Slow, shallow respiration, apnea, suppression of cough reflex, laryngospasm, bronchospasm
  • GU: Ureteral spasm, spasm of vesical sphincters, urinary retention or hesitancy, oliguria, antidiuretic effect, reduced libido or potency
  • EENT: Diplopia, blurred vision
  • Dermatologic: Rash, hives, pruritus, flushing, warmth, sensitivity to cold
    Local: Phlebitis following IV injection, pain at injection site; tissue irritation and induration (SC injection)
  • Other: Physical tolerance and dependence, psychological dependence; local skin irritation with transdermal system

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