ALFENTANIL

Alfentanil is a short-acting opioid analgesic related to fentanyl. It binds with stereospecific receptors within the CNS, thereby altering pain perception, increasing pain threshold, and inhibiting ascending pain pathways.

Uses

Alfentanil is an adjunct in the maintenance of general anesthesia. It is also used to induce spontaneous respiration and assisted ventilation, induction of anesthesia and analgesia in patients with spontaneous respiration.

Warnings

Do not give Alfentanil in the following:

Obstructive airway disease
Respiratory depression
Supervision in labour or before clamping of cord during caesarean section
Simultaneous use during or within 14 days of MAOI therapy

Side Effects

Alfentanil may give rise to the following:

Hypotension
Bradycardia
Drug dependency
Exaggerated elevation of intracranial pressure
Skeletal muscle rigidity
Fatigue
Agitation
Euphoric mood
Disorientation
Movement disorder
Dizziness
Sedation
Dyskinesia
Headache
Somnolence
Unresponsive to stimuli
Loss of consciousness
Convulsion
Myoclonus
Apnoea
Tachycardia
Arrhythmia
Decreased heart rate
Cardiac arrest
Hypertension
Nausea
Vomiting
Hiccups
Laryngospasm
Cough
Hypercapnia
Visual disturbance
Miosis
Dermatitis
Hyperhidrosis
Erythema
Rash
Chills
Injection site pain
Pyrexia
Respiratory depression

Precautions

Precautions

Take extra precautions in the following diseases:

Hypovolemia
Cardiovascular disease
Bradyarrhythmias
History of drug abuse or acute alcoholism
Head injury
Intracranial lesions
Increased intracranial pressure
Pulmonary disease
Decreased respiratory reserve
Compromised respiration
COPD or other obstructive pulmonary disease
Kyphoscoliosis or other skeletal disorder
Compromised intracerebral compliance
Hypothyroidism
Renal and hepatic impairment
Weak and elderly patients, children
Pregnancy and lactation

Interactions

Alfentanil may interact with the following medications:

CYP3A4 isoenzyme inhibitors (e.g. ketoconazole, itraconazole, fluconazole, voriconazole, ritonavir, erythromycin, diltiazem, cimetidine)
Barbiturates
Benzodiazepines
Neuroleptics
Halogenic gases
Non-selective CNS depressants (e.g. alcohol)
Propofol
Drugs that depress the heart or increase vagal tone (e.g. β-blockers, anaesth agents)
Non-vagolytic muscle relaxants
MAOIs