Fentanyl

Fentanyl is the medicine relating to group of opioid analgetics.

Pharmacological effect of Fentanyl

Fentanyl represents the synthetic analgetic possessing short-term and bystry anesthetic and sedative action. Repeatedly surpasses Morphine in the analgeziruyushchy ability.

Drug makes the oppressing impact on the vasomotor and respiratory centers. Excites the emetic center, and also the centers of a vagus nerve. Fentanyl raises a tone of sphincters of uric and bilious bubbles. Reduces a renal blood stream, a peristaltics of intestines and arterial pressure. Promotes approach of a physiological dream, causes euphoria.

Speed of development of tolerance and medicinal dependence to the anesthetizing effect of Fentanyl differs in significant individual differences.

Drug causes histamine reactions, than other opioid analgetics much less often.

In the instruction to Fentanyl it is noted that the maximum analgesic effect at intravenous administration of drug is noted in 3 minutes, and at intramuscular – in half an hour. Duration of its action at intravenous administration makes one hour, at intramuscular – 2 hours, and when using the transdermal therapeutic system (TTS) – till 72 o'clock.

Indications

Fentanyl in injections is used:

• For stopping of a pain syndrome (postoperative pains, an injury, at oncological patients, a myocardial infarction);
• For carrying out premedication;
• For carrying out a neuroleptanalgesia.

The form of production of Fentanyl in the form of the transdermal therapeutic system (TTS) is intended for treatment of the chronic pain syndrome caused by oncological pathology and some other diseases (an infection of Varicella zoster, a neuropathy, etc.).

Contraindications

• Oppression of a respiratory center;
• Hypersensitivity;
• Bronchial asthma;
• Pregnancy and period of a lactation;
• Obstetric operations;
• Craniocereberal hypertensia;
• Drug addiction.

Side effects of Fentanyl

According to the instruction Fentanyl can lead to development of side effects from various systems:

• Respiratory system – respiratory depression up to its stop;
• The central nervous system and sense bodys – drowsiness, a headache, a sight illegibility, euphoria increase in intracranial pressure;
• The alimentary system – nausea, vomiting, a lock, bilious colic;
• Cardiovascular system – a lowering of arterial pressure, bradycardia up to a cardiac standstill;
• Urinary system – an acute ischuria;
• Allergic reactions – a skin itch, a fever, a laryngospasm, a bronchospasm.

The form of production of Fentanyl in the form of a plaster can lead to emergence in the place of application of burning sensation, an itch, erubescence. These phenomena disappear within a day after removal of a plaster.

Reception of Fentanyl can lead to development of medicinal dependence.

Fentanyl overdose

At overdose of this medicine the emergency medical care is necessary. A specific antidote of Fentanyl is Naloxonum. The supporting and symptomatic therapy (transfer into IVL, introduction of Atropini sulfas, completion of OTsK) is carried out.

Fentanyl route of administration

According to the instruction to Fentanyl depending on a clinical situation intravenous or intramuscular administration of drug in a dose from 2,5 to 150 mkg is appointed to kg of body weight of the patient. Intervals between introductions are defined by the doctor individually.

When using TTS the dose depends on a condition of the patient, and also efficiency of this method of treatment.

Special instructions

According to the instruction Fentanyl has to be used only by medical personnel ready to holding in case of need resuscitation actions.

When using a plaster it is necessary to avoid solar bathtubs, visits of saunas.

During treatment patients are forbidden to be engaged in performance of work of the demanding high concentration of attention and speed of reaction.

It is forbidden to carry out a neuroleptanalgesia in the absence of the necessary equipment for carrying out artificial ventilation of the lungs.

Release form

Fentanyl for injections is produced in the form of 0,005% of solution in ampoules on 2,0 and 5,0 ml.

Fentanyl also is a part of TTS, having a plaster appearance with the special membrane regulating the speed of release of active agent.

Storage conditions

Fentanyl belongs to the list A and has to be stored by the rules established for storage of narcotic drugs.