VOL: 101, ISSUE: 24, PAGE NO: 29
Generic and proprietary names
- Fentanyl acts in the central nervous system (CNS) to relieve pain.
- Functional class: opioid analgesic.
- Chemical class: synthetic phenylpiperdine or phenylpiperdine derivative.
- The treatment of breakthrough cancer pain in patients receiving opioid therapy.
- Analgesia during operations, enhancement of anaesthesia.
- Acute respiratory depression.
- Acute alcoholism.
- Raised intracranial pressure such as in head injury.
- Asthma or decreased respiratory reserve.
- Hepatic impairment.
- Older people or those who are debilitated may need a reduced dose.
- Nausea and vomiting.
- Difficulty with micturition.
- Dry mouth.
- Postural hypotension.
- Alcohol will enhance the drug’s hypotensive and sedative effects.
- For breakthrough cancer pain:
- During anaesthesia:
- Intravenous injection;
- Intravenous infusion.
- Repeated intraoperative doses can cause respiratory depression to persist into the postoperative period.
- Fentanyl interferes with respiratory function and pupil reaction, both of which are essential parts of neurological assessment.
- Assess the therapeutic response and in breakthrough cancer pain consider adjustment of background analgesia where this is appropriate.
- Excessive heat may increase absorption from patches so local heat should not be applied and patients with fever should be carefully monitored.
- Medication should be kept out of reach of children and in its original packaging.
- Avoid activities that require alertness if patient is affected by drowsiness.
- Lozenges should be removed from foil just before administration and sucked over a 15-minute period, not chewed.
- Patches should be applied to dry, intact skin, non-irradiated non-hairy skin on the torso or upper arm. Replacement patches should be sited on a different area.
Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines