These symptoms could be troublesome in patients with cardiac disease e. Moderate The plasma concentrations of alfentanil may be elevated when administered concurrently with cobicistat. Laryngospasm was defined as prolonged obstruction with an apparently correctly placed cLMA. Patients should be monitored more closely for hypotension if nitroglycerin is used concurrently with opiate agonists. Due to the extremely long half-life of amiodarone, a drug interaction is possible for days to weeks after amiodarone discontinuation. Use of an alternative agent is recommended.
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Moderate Monitor patients for bradycardia and hypotension when alfentanil is coadministered with nimodipine. Monitor for hypertension and ensure ready availability of vasodilators and beta-blockers for the treatment of hypertension if alfentanil is administered to patients who have received MAO inhibitors allfentanil 14 days. Moderate Concomitant use of alfentanil with other CNS depressants e.
Practical aspects of alfentanil infusion.
Moderate Monitor patients for signs of urinary retention or reduced gastric motility when alfentanil is used concomitantly with an anticholinergic drug, such as solifenacin. Posaconazole is a potent inhibitor of CYP3A4, an isoenzyme responsible for the metabolism of alfentanil.
Mouth opening and ease of insertion were excluded because these variables were also influenced by anatomical features of the upper airway. Moderate Lumacaftor; ivacaftor may decrease the systemic exposure and therapeutic efficacy of alfentanil. Alfentanil is a CYP3A4 substrate.
The duration of respiratory depression may last longer than the effect of naloxone. For Intermezzo brand of sublingual zolpidem tablets, reduce the dose to 1.
Moderate Opiate agonists e. Patients should limit activity until they are aware of how coadministration affects them.
Major When naltrexone is used as adjuvant treatment of opiate or alcohol dependence, use is contraindicated in patients currently receiving opiate agonists. Miosis is produced by an excitatory action on the autonomic segment of the nucleus of the oculomotor nerve. Several factors contraindicate the use of alfentanil by epidural administration. A reduced dosage of alfentanil may be necessary if use together is not avoidable. Alfentanil is metabolized by the hepatic isoenzyme CYP3A4; boceprevir inhibits this isoenzyme.
The increase in alfentanil concentrations can increase the risk for serious CNS depression and respiratory depression, particularly when mifepristone is added after a stable dose of alfentanil is achieved.
Scottish Palliative Care Guidelines – Alfentanil
In some cases of acute pain, trauma, or during surgical management, opiate-dependent patients receiving buprenorphine maintenance therapy may require concurrent treatment with opiate agonists, such as alfentanil. In a recent publication from our department, propofol 2. If these drugs are used together, monitor patients for suboptimal efficacy of alfentanil; consider increasing the dose of alfentanil if necessary.
Restlessness, anxiety, tinnitus, dizziness, blurred vision, tremors, depression, or drowsiness may be early warning signs of CNS toxicity.
Combining alfentanil with clozapine may also lead to additive effects on intestinal motility or bladder function. The use of alfentanil in patients who have received MAOI therapy within 14 days is not recommended. Major Concomitant use of opiate agonists with deutetrabenazine may cause respiratory depression, hypotension, profound sedation, and death.
Your Name Your name is required. Opiate agonists impair the peristaltic activity of the intestine. When permissible, consider repositioning patient to improve venous return to the heart. Nevertheless, alfentanil should be used cautiously in patients with biliary tract disease, or in those who are undergoing surgery of the biliary tract.
Once removed from the refrigerator, the solution should be used within 24 hours. Chlorpheniramine; Guaifenesin; Alventanil Pseudoephedrine: Prior to concurrent use of an opiate in patients taking a CNS depressant, assess the level of tolerance to CNS depression that has developed, the duration of use, and the patient’s overall response to treatment.
Practical aspects of alfentanil infusion.
Alfentanil is a sensitive CYP3A4 substrate. Dose—response curves for optimum score. These events are associated with opiate-induced lowering of mean arterial pressure, which stimulates a regulatory response to increase cerebral blood flow leading to increased ICP.