Respiratory: respiratory depression or arrest, bronchoconstriction, laryngospasm
GI: nausea/vomiting, constipation
Use with caution in head injuries, suspected or known increased intracranial pressure; the elderly, debilitated or immuno-compromised patients; COPD or other respiratory problems and those with kidney or liver dysfunction.
Alcohol and other CNS depressants potentiate effects of fentanyl; MAO inhibitors may precipitate hypertensive crisis.
IV, IO, IM (also found in home medication form in the transdermal patch)
onset and duration
Onset is immediate; peak effect in 3-5 min IV, 5-15 IM; duration is 30-60 minutes (or hours with transdermal patch).
Adult: 25-100 mcg SLOW IV push (over 2-3 minutes)
Pediatric (child > 2 years): 2.0 mcg/kg SLOW IV push or IM
Fentanyl provides much faster acting, more prolonged pain relief. Duration of respiratory depressant effects may be significantly longer than analgesic effects – always have oxygen immediately available and be prepared with intubation equipment and a narcotic antagonist (i.e. naloxone).