Classes
DEA Class; Rx
Common Brand Names; Sufenta
- Opioid Analgesics;
- Synthetic, Opioids
Description
May open K+ channels and inhibit Ca++ channels, causing an increase in pain threshold and alteration in pain perception. It also inhibits ascending pain pathways
Indications
Indicated for Anesthesia
Contraindications
Hypersensitivity to drug or excipients
Adverse Effects
Nausea
Vomiting
Constipation
Sweating, flushing, warmness of the face/neck/upper thorax
Pruritus, urticaria
Bradycardia
Dizziness
Visual disturbances
Mentalclouding/depression
Sedation
Coma
Euphoria/Dysphoria
Weakness
Faintness
Agitation
Restlessness
Nervousness
Seizures
Warnings
Use caution in bradycardia, compromised cardiac reserve, head injury, hypothyroidism, increased intracranial pressure, intracranial lesions, renal function impairment, respiratory impairment
In patients who may be susceptible to intracranial effects of CO2 retention (eg, those with evidence of increased intracranial pressure or brain tumors), therapy may reduce respiratory drive, and resultant CO2 retention can further increase intracranial pressure; monitor such patients for signs of sedation and respiratory depression, particularly when initiating therapy; opioids may obscure clinical course in a patient with a head injury; avoid the use in patients with impaired consciousness or coma
May cause spasm of sphincter of Oddi; opioids may cause increases in serum amylase; monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms
Therapy may increase frequency of seizures in patients with seizure disorders and in other clinical settings associated with seizures; monitor patients for worsened seizure control during therapy
Therapy may impair mental or physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery; warn patients not to drive or operate dangerous machinery after receiving therapy
Life-threatening respiratory depression is more likely to occur in elderly, cachectic, or debilitated patients because they may have altered pharmacokinetics or altered clearance compared to younger, healthier patients; monitor closely
Pregnancy and Lactation
Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome; available data in pregnant women are insufficient to inform a drug-associated risk for major birth defects and miscarriage
The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy; capsules and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition
Maximum Dosage
Adults
Anesthesia
Induction/intubation: 1-2 mcg/kg IV, THEN 10-50 mcg IV PRN
General Anesthesia: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRN
Should be administered with 100% O2, with ventilatory support
Dose should be calculated based on ideal body weight
Other Indications & Uses
Low dose: Analgesia in intubation, ventilation (adjunct)
High dose: Primary anesthesia induction & maint
Epidural analgesia (with bupivacaine)
Pediatric
Anesthesia
<2 years: Safety and efficacy not established
2-12 years: 10-25 mcg/kg IV increments
>12 years: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRN
Geriatric
Induction/intubation: 1-2 mcg/kg IV, THEN 10-50 mcg IV PRN
General Anesthesia: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRN
Should be administered with 100% O2, with ventilatory support
Dose should be calculated based on ideal body weight
How supplied
Sufentanil Citrate
injectable solution: Schedule II
- 0.05mg/mL