Fentanyl is a narcotic classified as an opioid analgesic and general anesthetic. It is available as an injection, patch, buccal tablet and lozenge. Fentanyl is prescribed according to the indication for which the drug is being used.
General Anesthesia
Fentanyl injection may be given intravenously or intramuscularly in adults and children. The "Drug Information Handbook" explains that it is used in combination with general anesthesia.
Acute Pain Management
The injection form of fentanyl may also be used to treat acute, or short-term, pain management. This indication is only approved in adults
Breakthrough Cancer Pain
Cancer patients take a long-acting medication to treat pain and a short-acting medication for breakthrough pain, which occurs in between doses of the long-action drug. Fentanyl buccal tablets and lozenges are used for breakthrough cancer pain. The buccal tablets should be place between the upper cheek and gum. The lozenge should be placed in the mouth and allowed to dissolve.
Chronic Pain Management
The patch, or transdermal, form of fentanyl is available for the treatment of chronic pain in adults. The patch is placed on a clean, hairless part of the body for 72 hours. "Pharmacotherapy: A Pathophysiologic Approach" states that the patch must never be used for breakthrough pain.
Monitoring
Monitoring parameters for fentanyl include respiratory rate, cardiovascular status, blood pressure and heart rate. Patients should also be monitored for signs of abuse, misuse or addiction.
References
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al.; 2008
