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19 Cards in this Set
- Front
- Back
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IN Fentanyl initial dose for pt (a) <60 years and >60 kg
and (b) >60 years and/or <60 kg |
(a) 200 mcg IN
(b) 100 mcg IN |
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IN Fentanyl initial volume for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) 0.66 mL + 0.1 mL rounded to nearest 0.05 mL
= 0.75 mL IN (b) 0.33 mL + 0.1 mL rounded to nearest 0.05 mL = 0.45 mL IN |
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IN Fentanyl subsequent dose for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) + (b) 25 - 50 mcg IN
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IN Fentanyl subsequent volume for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) + (b) 0.08 - 0.16 mL + 0.1 mL rounded to nearest 0.05 mL
= 0.20 - 0.25 mL IN |
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IN Fentanyl max dosage for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) 400 mcg IN
(b) 200 mcg IN |
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IN Fentanyl repeat dose and timing for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) + (b) repeat up to 50 mcg IN @ 5/60 titrated to pain and side effects until max dose reached
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IV Fentanyl indications
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Unable to administer IN route and methoxyflurane not controlling pain
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IV Fentanyl initial dose for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) + (b) 25 - 50 mcg IV (0.2 0.25 mL)
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IV Fentanyl subsequent dose and timing for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) + (b) repeat 25 - 50 mcg IV (0.2 0.25 mL) @ 5/60 titrated to pain and side effects until max dose reached
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IV Fentanyl max dose for pt (a) <60 years and >60 kg and (b) >60 years and/or <60 kg
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(a) + (b) 200 mcg IV
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Fentanyl presentation
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100mcg/2mL glass ampoule 200mcg/1mL glassvial (IN use only) 600mcg/2 mL glass vial (IN use only) |
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Fentanyl pharmacology
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A synthetic opioid analgesic -depression leading to analgesia Cardiovascular effects -Decreases conduction velocity through AV node |
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Metabolism
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by the liver and excreted by the kidneys
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PEI (4)
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-Sedation to facilitate intubation
-Sedation to maintain intubation -Drug facilitated intubation -Analgesia IN/IV |
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CI (1)
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Known hypersensitivity
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Precautions (7)
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1. Frail pts
2. Impaired renal/hepatic function 3. Respiratory depression eg COPD 4. Current asthma 5. Pts on MAOIs 6. Known addiction to opioids 7. Rhinitis, rhinorrhea or facial trauma (IN route) |
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Fentanyl routes
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IV
IN |
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SE (4)
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-Respiratory depression
-Apnoea -Rigidity of the diaphragm and intercostal muscles -Bradycardia |
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OPD
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IV onset immediate
IV peak <5 min IV duration 30 - 60 min IN peak 2 mins |
