{"id":3671,"date":"2025-03-31T18:11:47","date_gmt":"2025-03-31T18:11:47","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/alfentanil-txt\/"},"modified":"2025-03-31T18:11:47","modified_gmt":"2025-03-31T18:11:47","slug":"alfentanil-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/alfentanil-txt\/","title":{"rendered":"Alfentanil.txt"},"content":{"rendered":"

Alfentanil<\/h1>\n

CLINICAL USE <\/H3>
\nOpioid analgesic:<\/p>\n
  • Short surgical procedures\n
  • Intensive care sedation\n

    DOSE IN NORMAL RENAL FUNCTION <\/H3><\/p>\n
  • IV injection:\n

    Spontaneous respiration: up to <\/p>\n

    \u2014
    \n500 micrograms over 30 seconds;
    \nsupplemental dose: 250 micrograms
    \nassisted ventilation: 30\u201350 <\/p>\n

    \u2014
    \nmicrograms\/kg; supplemental dose:
    \n15 micrograms\/kg<\/p>\n

  • By IV infusion with assisted ventilation:\n

    loading dose 50\u2013100 micrograms\/kg as
    \nbolus or fast infusion over 10 minutes,
    \nfollowed by 0.5\u20131 micrograms\/kg\/minute.
    \nDiscontinue infusion 30 minutes before
    \nanticipated end of surgery<\/p>\n

  • For analgesia and suppression of\n

    respiratory activity during intensive care
    \nwith assisted ventilation: by IV infusion
    \n2 mg\/hour, adjusted according to response
    \n(usual range 0.5\u201310 mg\/hour)<\/p>\n

  • For more rapid initial control give 5 mg\n

    IV in divided portions over 10 minutes
    \n(slower if hypotension or bradycardia
    \ndevelops); additional doses of 0.5\u20131 mg
    \nmay be given by IV injection during short
    \npainful procedures
    \n

    PHARMACOKINETICS <\/H3>
    \n
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n453 (as hydrochloride)\n<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \n92\n<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp :
    \n0.4\n<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :
    \n0.4\u20131\n<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :
    \n1\u20132 (average
    \n90 minutes)\/
    \nUnchanged
    \n

    DOSE IN RENAL IMPAIRMENT <\/H3>
    \n

    GFR (mL\/MIN)<\/H4>
    \n
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
    \n
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
    \n
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nDose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
    \n
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in normal renal function <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    \nNot dialysed. Dose as in normal renal function
    \n
  • HDF\/high flux &nbsp :
    \nUnknown dialysability. Dose as in
    \nnormal renal function
    \n
  • CAV\/VVHD &nbsp &nbsp &nbsp:
    \nNot dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS <\/H3>
    \nPotentially hazardous interactions with other drugs<\/p>\n
  • Antidepressants: possible CNS excitation\n

    or depression (hypertension or
    \nhypotension) in patients also receiving
    \nMAOIs (including moclobemide) \u2013 avoid
    \nconcomitant use; possibly increased
    \nsedative effects with tricyclics<\/p>\n

  • Antifungals: metabolism inhibited by\n

    fluconazole and ketoconazole (risk
    \nof prolonged or delayed respiratory
    \ndepression); metabolism possibly inhibited
    \nby itraconazole<\/p>\n

  • Antivirals: concentration possibly\n

    increased by ritonavir<\/p>\n

  • Sodium oxybate: enhanced effect of\n

    sodium oxybate \u2013 avoid concomitant use
    \n

    ADMINISTRATION <\/H3>
    \n

    Reconstition<\/H4>
    \n\u2013
    \n

    Route <\/H4>
    \nIV bolus,

    IV infusion <\/H4><\/p>\n

    Rate of Administration <\/H4>
    \nSee dose<\/p>\n

    Comments<\/H4><\/p>\n
  • Alfentanil can be mixed with sodium\n

    chloride 0.9%, glucose 5%, or compound
    \nsodium lactate injection (Hartmann\u2019s
    \nsolution) at a concentration of 0.5 mg\/
    \nmL, but can be used at 2 mg\/mL or even
    \nundiluted at 5 mg\/mL. <\/p>\n

    OTHER INFORMATION <\/H4><\/p>\n
  • Free fraction of drug is increased in renal\n

    failure, hence dose requirements may be
    \nreduced<\/p>\n

  • IV administration: 500 micrograms\n

    alfentanil has peak effect in 90 seconds,
    \nand provides analgesia for 5\u201310 minutes
    \n(in unpremedicated adults)<\/p>\n

  • Transient fall in BP and bradycardia may\n

    occur on administration<\/p>\n

  • Analgesic potency = \u00bc that of fentanyl\n

    Duration of action = \u2153 that of an equi-<\/p>\n

    analgesic dose of fentanyl<\/p>\n

  • Onset of action = 4 times more rapid than\n

    an equi-analgesic dose of fentanyl<\/p>\n","protected":false},"excerpt":{"rendered":"

    Alfentanil CLINICAL USE Opioid analgesic: Short surgical procedures Intensive care<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3671","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3671","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3671"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3671\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3671"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3671"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3671"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}