Fentanyl (When ATH N01AH01)

When ATH:
N01AH01

Characteristic.

The white crystalline powder. Practically insoluble in water, easily soluble in alcohol.

Pharmacological action.
Analgesic (opioid).

Application.

Premedication before surgery, induction of anesthesia, Postoperative analgesia, neuroleptanalgesia, severe pain, chronic pain in cancer; nekupiruyuschiesya pain (Applique patch).

Contraindications.

Hypersensitivity, bronchial asthma, depression of the respiratory center, cranial hypertension, Obstetric surgery, addiction, pregnancy, lactation.

Side effects.

Gipoventilyatsiya, respiratory depression, up to the stop (large doses), bronchospasm, paradoxical CNS stimulation, confusion, hallucinations, short-term stiffness (incl. infants), bradycardia, nausea, vomiting, constipation, pečenočnaâ how, urinary retention, amblyopia; patch: local skin reactions-rash, эritema, itch (disappear within 24 hours after patch removal).

Cooperation.

The effect decreases buprenorphine. Opiates, sedatives, hypnotics, fenotiazinы, trankvilizatorы, for narcosis, muscle relaxants, antihistamines, causing sedation, alcohol and other means deprimiruyuschie increase the likelihood of adverse events (CNS depression, gipoventilyatsiya, hypotension, and others.). Benzodiazepines extend out of neuroleptanalgesia. Dinitrogen oxide increases muscle rigidity, antihypertensives-hypotension, MAO inhibitors-risk of severe complications.

Overdose.

Symptoms: respiratory depression.

Treatment: naloxone, inhalation of oxygen, IVL, If you use the patch-immediate removal.

Dosing and Administration.

B /, / m, locally (transdermal system in the form of a patch). For premedication and postoperative period/m-on 0.05-0.1 mg, Children - 0,002 mg / kg; for the induction narcosis-/in the 0.1-0.2 mg; neiroleptanalgesia-in/0.2-0.6 mg (administration repeated every 20 m); open heart operations-0.05-0.1 mg/kg. Locally — on 72 h impose on the flat surface of the skin (nerazdrazhennuyu, with minimal scalp, if necessary washed pure water, without the use of detergents and thoroughly dried) and tightly pressed (application site alternate). Dose picked individually. Patients, previously did not take opiates, -initial dose 25 g / h; opiate tolerance in the transition to the initial treatment fentanyl dose is calculated according to the relevant tables, based on the previous daily needs for analgesics; When using a dose more 300 mcg/h extra or alternative methods of introduction.

Precautions.

Abolition of the drug gradually produce. When using high doses of malnourished and adynamic patients may develop secondary respiratory depression, fentanyl allocation through 1-2 h after the introduction in the lumen of the stomach and subsequent resorption. Application of the plaster is not recommended for acute or postoperative pain (due to the impossibility titration in a short period of treatment and risk of hypoventilation), women of childbearing age, and requires care for chronic, incl. obstructive pulmonary disease (possible depression of the respiratory center), disturbance of consciousness, whom, brain tumors, ʙradiaritmijax, hepatic and renal failure, in elderly and childhood. By using the plaster is recommended to avoid direct exposure to external heat sources (Warmer, saunas, sunbathing and others.). During treatment, should not engage in potentially hazardous activities, require increased attention and psychomotor reactions.

Cautions.

Neuroleptanalgesia unacceptable conduct in the absence of conditions for mechanical ventilation.

Cooperation