Trade Names:Ultiva- Powder for injection, lyophilized 1 mg/mL after reconstitution
Plasma concentrations are proportional to the administered dose.
Initial Vd is approximately 100 mL/kg and distributes into peripheral tissue with a Vd at steady state of approximately 350 mL/kg. Plasma protein binding is approximately 70%.
Metabolized by nonspecific esterases in blood and tissue.
Elimination t ½ is approximately 3 to 10 minutes.
The clearance is reduced approximately 25%.Children
In children, 5 days to 17 yr of age, the clearance and Vd are increased.
Analgesic for use during the induction and maintenance of general anesthesia for inpatient and outpatient procedures and for continuation as an analgesic into the immediate postoperative period under supervision of an anesthesia practitioner; as an analgesic component of monitored anesthesia care.
Epidural or intrathecal administration; hypersensitivity to fentanyl analogs; any component of the product.
Not recommended as the sole agent in general anesthesia.Adults
Induction of anesthesia through intubation:
IV 0.5 to 1 mcg/kg/min by continuous infusion. If endotracheal intubation is to occur less than 8 min after the start of infusion, then an initial dose of 1 mcg/kg may be given over 30 to 60 sec.Maintenance Of Anesthesia With Nitrous Oxide (66%)Adults
IV 0.4 mcg/kg/min by continuous infusion (range, 0.1 to 2 mcg/kg/min), supplemental bolus dose of 1 mcg/kg.Maintenance of Anesthesia with Isoflurane (0.4 to 1.5 MAC) or Propofol (100 to 200 mcg/kg/min)Adults
IV 0.25 mcg/kg/min (range, 0.05 to 2 mcg/kg/min), supplemental bolus of 1 mcg/kg.Continuation As An Analgesic Into Immediate Postoperative PeriodAdults
IV 0.1 mcg/kg/min (range, 0.025 to 0.2 mcg/kg/min), supplemental bolus not recommended.Analgesic Component Of Monitored Anesthesia Care
Supplemental oxygen should be supplied.Adults
Single dose: IV 0.5 to 1 mcg/kg administered over 30 to 60 sec given 90 sec before placement of the local or regional anesthetic block.Adults
Continuous infusion: IV 0.1 mcg/kg/min beginning 5 min before placement of local or regional anesthetic block.Individualization of DosageElderly (over 65 yr of age)
IV Decrease the starting dose by 50% and cautiously titrate to effect.Children (2 yr and over)
IV Same doses per kg as adults.Obesity
IV Base starting dose on ideal body weight in patients more than 30% over ideal body weight.
Store powder for injection in refrigerator (36° to 46°F) or at room temperature (less than 78°F). Reconstituted and diluted solutions are stable for up to 24 hr at room temperature.
Withdrawal may be precipitated.Barbiturate anesthetics
May cause increased CNS and respiratory depression.
None well documented.
Bradycardia; hypotension; tachycardia; hypertension; premature ventricular beats; MI; atrial fibrillation; atrial flutter; decreased cardiac output; arrhythmia; ventricular fibrillation; third degree heart block.
Dizziness; agitation; headache; somnolence; anxiety; hallucinations; decreased mental acuity.
Visual disturbance; pharyngitis.
Nausea; vomiting; constipation.
Coagulation disorder; hemorrhage; anemia; thrombocytopenia.
Respiratory depression; apnea; pleural effusion; pneumonia; cough; dyspnea.
Skeletal muscle rigidity; shivering; chills; fever; postoperative pain; hypoxia; sweating; flushing; warm sensation; pain at IV site; postoperative and perioperative complications; involuntary movements; edema; heartburn.
Category C .
Safety and efficacy not established in children younger than 2 yr of age.
Reduce dose in patients older than 65 yr of age.
Has abuse potential of the morphine type.
Extension of the pharmacologic effects including, apnea, chest-wall rigidity, seizures, hypoxemia, hypotension, bradycardia
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