Trade Names:Alfenta- Injection 500 mcg (as hydrochloride)/mL
Binds opioid receptors in CNS.
Vd is 0.4 to 1 L/kg. Protein binding is about 92%. Sequential distribution t ½ is 1 and 14 min.
Metabolized in the liver.
Terminal t ½ is 90 to 111 min. Plasma Cl is about 5 mL/kg/min. One percent is excreted as unchanged drug; urinary excretion is the major route for metabolites.
Reduced plasma Cl and extended terminal elimination may develop.Elderly
Reduced plasma Cl and extended terminal elimination may develop.
Induction of analgesia and anesthesia in specific situations, monitored anesthesia care (MAC).
Hypersensitivity to narcotics; diarrhea caused by poisoning until toxic agent is identified; acute bronchial asthma; upper airway obstruction.
Calculate dosage on basis of lean body weight.Spontaneously Breathing/Assisted VentilationAdults (initial dose)
IV 8 to 20 mcg/kg.Adults (maintenance dose)
IV 0.5 to 1 mcg/kg/min.Incremental InjectionAdults (initial dose)
IV 20 to 50 mcg/kg.Adults (maintenance dose)
IV 5 to 15 mcg/kg every 5 to 20 min.Anesthetic InductionAdults (initial dose)
IV 130 to 245 mcg/kg.Adults (maintenance dose)
IV 0.5 to 1.5 mcg/kg/min (or use general anesthetic).Continuous InfusionAdults (initial dose)
IV 50 to 75 mcg/kg.Adults (maintenance dose)
IV 0.5 to 3 mcg/kg/min.MACAdults (initial dose)
IV 3 to 8 mcg/kg; total dose, 3 to 40 mcg/kg.Adults (maintenance dose)
IV 3 to 5 mcg/kg every 5 to 20 min to 1 mcg/kg/min.
Reduces alfentanil Cl.CNS depressants
May increase CNS and CV effects of alfentanil.Diazepam
May produce CV depression when given with high doses of alfentanil.Erythromycin
May increase levels of alfentanil, causing prolonged or delayed respiratory depression.Protease inhibitors
May increase CNS and respiratory depression.
Amylase or lipase concentration test results may be unreliable for 24 h after administration of alfentanil.
Hypotension; hypertension; tachycardia; bradycardia; asystole hypercarbia; arrhythmia.
Respiratory depression; bronchospasm; apnea.
Category C .
Hypotension has occurred in newborns receiving alfentanil. Not recommended for children under 12 yr of age.
Decreased dosage may be necessary.
Narcotics cross placenta and can affect newborn.
Drug may cause bradycardia and hypotension; may aggravate arrhythmias.
Patient may be sensitive to depressive effects of alfentanil.
Alfentanil may increase intracranial pressure.
Alfentanil may decrease respiratory drive and cause apnea.
Alfentanil may cause or aggravate seizure disorder.
Alfentanil may cause skeletal muscle rigidity, particularly of the truncal muscle.
Respiratory depression, CNS depression, circulatory collapse (usually after rapid IV administration).
Copyright © 2009 Wolters Kluwer Health.