Fentanyl

Fentanyl

Trade names	Actiq, Duragesic, Sublimaze
Clinical data
Drug class	Opioid
Uses	Analgesia
Routes of administration	Buccal, Epidural, Intrathecal, Intravenous, Transdermal
Dosage
Fentanyl Adult dosing 25-100 mcg IV 0.5-2 mL of 50 mcg/mL More information about this dose Weight kglbg Height cmminft Age yrmowk SexFM Indication  Indication: AnalgesiaIntubation Route  Route: IntravenousIntranasal Preparation  Preparation: 50 mcg/mL Ingrande J, Lemmens HJ. Dose adjustment of anaesthetics in the morbidly obese. Br J Anaesth. 2010 Dec;105 Suppl 1:i16-23. doi: 10.1093/bja/aeq312. PMID: 21148651.
Pharmacodynamics
Mechanism of action	μ-opioid agonism
Pharmacokinetics
Onset of action	5 minutes
Duration of action	30-60 minutes
Metabolism	Hepatic (CYP3A4)
Redistribution half-life	6 minutes (initial) 1 hour (slow)
Elimination half-life	16 hours
Protein binding	80-85%
Physical and chemical data
Formula	5 minutes
Molar mass	336.479 g/mol
Article quality
Editor rating	In development
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Fentanyl is a synthetic, lipophilic phenylpiperidine opioid agonist used for analgesia. It is highly lipophilic leading to fast passage across the blood-brain barrier with a 6.8 minute onset time. Fentanyl will also rapidly redistribute to adipose and fatty tissue leading to a short duration of action.

Uses

• Administration
  • IV, IM, transdermal, intranasal, intrathecal, epidural, buccal.

Pharmacology

Pharmacodynamics

Mechanism of action

• µ-selective opioid receptor
• Low affinity: delta & kappa opioid receptors

Pharmacokinetics

• Context Sensitive Half Time
  • Infusion or repeated doses lead to prolong duration of action as drug redistributes back from tissue to plasma.

References

1. Comer SD, Cahill CM. Fentanyl: Receptor pharmacology, abuse potential, and implications for treatment. Neurosci Biobehav Rev. 2019 Nov;106:49-57.