Fentanyl Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Fentanyl

Brand Name: Actiq; Duragesic 25, 50, 75, 100; Fentanyl Oralet; Sublimaze

Pregnancy Category B, C-II controlled substance

Drug class: Narcotic agonist analgesic

Therapeutic actions

Acts at specific opioid receptors, causing analgesia, respiratory depression, physical depression, euphoria.

Indications

· Analgesic action of short duration during anesthesia and immediate postop period

· Analgesic supplement in general or regional anesthesia

· Administration with a neuroleptic as an anesthetic premedication, for induction of anesthesia, and as an adjunct in maintenance of general and regional anesthesia

· For use as an anesthetic agent with oxygen in selected high-risk patients

· Transdermal system: management of chronic pain in patients requiring opioid analgesia

· Treatment of breakthrough pain in cancer patients being treated with narcotics (Actiq)

Contraindications

· Contraindicated with hypersensitivity to narcotics, diarrhea caused by poisoning, acute bronchial asthma, upper airway obstruction, pregnancy.

Adverse effects

Sedation, clamminess, sweating, headache, vertigo, floating feeling, dizziness, lethargy, confusion, light-headedness, nervousness, unusual dreams, agitation, euphoria, hallucinations, delirium, insomnia, anxiety, fear, disorientation, impaired mental and physical performance, coma, mood changes, weakness, headache, tremor, convulsions

Palpitation, increase or decrease in BP, circulatory depression, cardiac arrest, shock, tachycardia, bradycardia, arrhythmia, palpitations

Rash, hives, pruritus, flushing, warmth, sensitivity to cold

Diplopia, blurred vision

Nausea, vomiting, dry mouth, anorexia, constipation, biliary tract spasm

Ureteral spasm, spasm of vesical sphincters, urinary retention or hesitancy, oliguria, antidiuretic effect, reduced libido or potency

Drug Interactions:

· Potentiation of effects when given with other CNS acting drugs or barbiturate anesthetics; decrease dose of fentanyl when coadministering

Nursing considerations

CLINICAL ALERT!

Name confusion has occurred between fentanyl and sufentanil; use extreme caution.

· Administer to women who are nursing a baby 4–6 hr before the next scheduled feeding to minimize the amount in milk.

· Provide narcotic antagonist, facilities for assisted or controlled respiration on standby during parenteral administration.

· Prepare site for transdermal form by clipping (not shaving) hair at site; do not use soap, oils, lotions, alcohol; allow skin to dry completely before application. Apply immediately after removal from the sealed package; firmly press the transdermal system in place with the palm of the hand for 10–20 sec, making sure the contact is complete. Must be worn continually for 72 hr.

· Use caution with Actiq form to keep this drug out of the reach of children (looks like a lollipop) and follow the distribution restrictions in place with this drug very carefully.