For analgesic action of short duration during anaesthesia. 

Narcotic Agonist Analgesics include-

Alfentanil, Codeine, Fentanyl, Hydrocodone, Levorphanol, Meperidine, Methadone, Morphine, Oxycodone, Propoxyphene PO, Sufentanil

Refer - Fentanyl  Drug

Respiratory depression, trunkal rigidity, laryngospasm, bronchoconstriction. Nausea, bradycardia, hypotension, pruritus, urinary retension,seizures.

Respiratory depression, COPD, raised intracranial pressure, hypovalaemia/hypotension, myasthenia gravis, concomittant use of MAO inhibitors or use within 2 weeks of stopping lactation.

Special precautions:

Respiratory depression may persist for several hours, muscle rigidity may worsen respiratory depression, head injury, elderly, debilitated subjects, renal or hepatic impairment, pregnancy.

Date of Approval       2006

Indications:

For analgesic action of short duration during anaesthesia.

Dosage:

Individualise dosage. Monitor vital signs routinely.

Premedication- 0.05 to0.1mg IM,30 to 60 minutes before surgery.

Narcotic agonist analgesics- Incudes-Alfentanil,Codeine, Hydrocodone, Hydromorphone, Levorphanol, Meperidine, Methadone, Morphine, Oxycodone, Oxymorphone, Propoxyphene (PO), Sufentanil.

1. May cause drowsiness, dizziness, or blurring of vision, use caution while driving or performing tasks requiring alertness.

2. Avoid alcohol and other sedative or drowsiness causing drugs.

3. May cause nausea, vomiting or constipation, notify physician, if these become prominent

4. If GI upset occurs, these agents may be taken with food.

5. Notify physician, if shortness of breath or difficulty in breathing occurs.

6. Allergies- Tell your doctor if you have ever had any unusual or allergic reactions to fentanyl , alfentanil or sufentanil. Also tell your doctor if your are allergic to any other substances such as foods, preservatives or dyes.

7. Pregnancy- using any narcotic regularly during pregnancy, may cause physical dependence in the fetus. Also use of this medicine near the end of pregnancy may cause drowsiness and breathing problems in newborn babies

8. Breast feeding- a mother who wishes to breast feed and who need treatment for continuing pain should discuss the risks and benefits of different pain treatment with her health care professional.

9. Elderly- elderly people are especially sensitive to the effects of narcotic analgesics. This may increase the chance of side rffects especially breathing problems during treatment.

10. Other medicines- tell your doctor if you are taking any of the following- Buprenorphine or Decocine or Nalbuphine or Pentozocine or - these medicines can cause withdrawal side effects if they are given to someone who is physically dependent on fentanyl CNS deprerssants- or Tricyclic antidepressants - these medicines may increase the chance of serious side effects Nlatrxone -fenatyl will not be efective in people taking naltrexone

11. Other medical problems- presence of other medical problems may affect the use of this medicine- Alcohol abuse or Drug dependence or Emotional problems or Kidney disease or Liver disease or Underactive thyroid or Brain tumor or Diarrhea casysed by antibiotic treatment or Emphsema, asthma, or other chronic lung disease or Enlarged prostrate or problems with urination or Gall bladder disease or gall stones or Intestinal problems such as colitis or Crohns disease - some of these side effects of fentanyl can cause serious problems in people who have these medical problems Slow heart beat- fentanyl can make the condition worse

12. Missed dose- If you miss a dose of this medicine take it as soon as possible. However if it is almost time for your next dose go back to your regular dosing schedule. Do not double doses.

May be taken with food.

Narcotic agonist analgesics-

Pregnancy:

safety for use during pregnancy has not been established. Use with caution.

Lactation:

Most of the agents appear in breast milk, but effects may not be significant. Some recommend waiting for 4 to 6 hours after use before nursing.