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Alfentanil (Efficacy)

Alfentanil is an opiate analgesic with a very rapid onset of action and short duration, derived from fentanyl (alfentanil presents 25% of fentanyl potency).

It is used as a supplement to anesthesia in neuroleptoanalgesia, in short-term and ambulatory surgery. It is also used as a general anesthetic inducer in combination with O2/NO.

CONTRAINDICATIONS

Hypersensitivity to morphinomimetics.

PRECAUTIONS

Precautions should be taken when prescribing alfentanil to patients with uncontrolled hypothyroidism, pulmonary disease, decreased respiratory reserve, alcoholism and impaired hepatic or renal function.

In patients with compromised intracerebral compliance, caution should be exercised and rapid bolus injection avoided.

In the elderly, lower doses of alfentanil should be prescribed. Patients on chronic treatment with opioids or with dependence require a higher dose of alfentanil. Alfentanil may produce respiratory depression, muscle rigidity, non-epileptic myoclonic movements, bradycardia, hypotension.

SIDE EFFECTS

Euphoria, movement and visual disorders, vertigo, sedation, dyskinesia, bradycardia and tachycardia, hypotension and hypertension. Apnea. Nausea, vomiting. Muscular stiffness. Fatigue, chills, pain at the injection site.

PHARMACOLOGICAL INTERACTIONS

Alfentanil can produce respiratory depression that is enhanced by: barbiturates, benzodiazepines, neuroleptics, halogenated gases and other central nervous system depressants; in these cases the dose of alfentanil should be reduced.

The metabolism of alfentanil is inhibited by: CYP3A4 inhibitors (fluconazole, voriconazole, erythromycin, diltiazem and cimetidine, ketoconazole, itraconazole, ritonavir); If taking alfentanil concomitantly with these substances the dose of alfentanil should be reduced.

The effect of alfentanil is potentiated by concomitance with MAOIs; do not use alfentanil if you have been treated with MAOIs in the previous 2 weeks.

Alfentanil increases blood levels of propofol.

BRAND NAME

  • Limifen ®

Gene or region studied

  • OPRM1
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