Home Drug Guide Alfentanil Hydrochloride

Drug Guide

Generic Name

Alfentanil Hydrochloride

Brand Names Alfenta

Classification

Therapeutic: Analgesic, Opioid

Pharmacological: Mu-Opioid Receptor Agonist

FDA Approved Indications

  • Anesthesia induction and maintenance during surgical procedures

Mechanism of Action

Alfentanil stimulates mu-opioid receptors in the central nervous system, resulting in analgesia and sedation.

Dosage and Administration

Adult: Dose varies; typically 10-20 mcg/kg administered intravenously before surgery, repeated PRN based on response.

Pediatric: Use with caution; dosing individualized based on weight and procedure.

Geriatric: Start at lower end of dosing range due to increased sensitivity.

Renal Impairment: Adjust dose carefully; renal impairment may prolong half-life.

Hepatic Impairment: Use with caution; monitor for prolonged effects.

Pharmacokinetics

Absorption: Immediate onset when administered IV.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Primarily by hepatic esterases and cytochrome P450 enzymes.

Excretion: Renal excretion of metabolites.

Half Life: Approximately 90-111 minutes.

Contraindications

  • Hypersensitivity to alfentanil or other opioids.
  • Respiratory depression.

Precautions

  • Use with caution in patients with compromised cardiopulmonary status, head injury, or increased intracranial pressure.
  • Monitor closely in elderly and renal/hepatic impairment.

Adverse Reactions - Common

  • Respiratory depression (Common)
  • hypotension (Common)
  • Nausea and vomiting (Common)

Adverse Reactions - Serious

  • Serious respiratory depression (Rare)
  • Anaphylaxis (Rare)
  • Bradycardia (Rare)

Drug-Drug Interactions

  • Other CNS depressants, sedatives, or anesthetics increase respiratory depression risk.
  • MAO inhibitors may enhance opioid effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor vital signs closely, especially respiration and blood pressure.

Diagnoses:

  • Impaired gas exchange
  • Risk for hypotension

Implementation: Administer IV as prescribed, titrate to effect, have resuscitation equipment ready.

Evaluation: Ensure adequate oxygenation, stable vital signs, and appropriate level of sedation.

Patient/Family Teaching

  • Report any difficulty breathing or excessive sedation.
  • Avoid operating machinery or driving after sedation.

Special Considerations

Black Box Warnings:

  • Potential for respiratory depression and death if improperly used.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Respiratory depression, unconsciousness, pinpoint pupils.

Treatment: Supportive care, airway management, administration of opioid antagonists such as naloxone.

Storage and Handling

Storage: Store in a secure area at room temperature, protected from light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.