User:Mr. Ibrahem/Fentanyl

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Mr. Ibrahem/Fentanyl
Clinical data
Pronunciation/ˈfɛntənɪl/ or /ˈfɛntənəl/
Trade namesActiq, Duragesic, Fentora, others
AHFS/Drugs.comMonograph
MedlinePlusa605043
License data
Pregnancy
category
  • AU: C
Dependence
liability		High[1]
Routes of
administration		Buccal, epidural, IM, IT, IV, sublingual, skin patch
Drug classOpioid
Legal status
Legal status
Pharmacokinetic data
Bioavailability92% (transdermal)
89% (intranasal)
50% (buccal)
33% (ingestion)
100% (intramuscular)/> 55% (inhaled)
Protein binding80–85%
MetabolismLiver, primarily by CYP3A4
Onset of action5 minutes[2]
Elimination half-lifeIV: 6 mins (T1/2 α)
1 hours (T1/2 β)
16 hours (T1/2 ɣ)
Intranasal: 6.5 hours
Transdermal: 20–27 hours[3]
Sublingual/buccal (single dose): 2.6–13.5 hours[3]
Duration of actionIV: 30–60 minutes[2][4]
ExcretionMostly urinary (metabolites, <10% unchanged drug)[3]
Identifiers
  • N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]propanamide
Chemical and physical data
FormulaC22H28N2O
Molar mass336.479 g·mol−1
3D model (JSmol)
Density1.1 g/cm3
Melting point87.5 °C (189.5 °F)
  • O=C(CC)N(C1CCN(CC1)CCc2ccccc2)c3ccccc3
  • InChI=1S/C22H28N2O/c1-2-22(25)24(20-11-7-4-8-12-20)21-14-17-23(18-15-21)16-13-19-9-5-3-6-10-19/h3-12,21H,2,13-18H2,1H3 checkY
  • Key:PJMPHNIQZUBGLI-UHFFFAOYSA-N checkY
  (verify)

Fentanyl, also spelled fentanil, is an opioid used as a pain medication and together with other medications for anesthesia.[3] Fentanyl is also used as a recreational drug, often mixed with heroin or cocaine.[7] It has a rapid onset and its effects generally last less than two hours.[3] Medically, fentanyl is used by injection, nasal spray, skin patch, or absorbed through the cheek (transmucosal) as a lozenge or tablet.[3][8]

Common side effects include vomiting, constipation, sedation, confusion, hallucinations, and injuries related to poor coordination.[3][9] Serious side effects may include decreased breathing (respiratory depression), serotonin syndrome, low blood pressure, addiction, or coma.[3][9] Fentanyl works primarily by activating μ-opioid receptors.[3] It is around 100 times stronger than morphine, and some analogues such as carfentanil are around 10,000 times stronger.[10]

Fentanyl was first made by Paul Janssen in 1960 and approved for medical use in the United States in 1968.[3][11] In 2015, 1,600 kilograms (3,500 lb) were used in healthcare globally.[12] As of 2017, fentanyl was the most widely used synthetic opioid in medicine.[13] Fentanyl patches for cancer pain are on the World Health Organization's List of Essential Medicines.[14] In 2016, fentanyl and analogues were the most common cause of overdose deaths in the United States at more than 20,000, about half of all opioid-related deaths.[15][16][17] Most of these overdose deaths were due to illegally made fentanyl.[18]

For a 100 microgram vial, the average wholesale cost in the developing world was US$0.66 in 2015.[19] In 2017, the price in the United States was US$0.49 for that same amount.[20] In the US, the 800 mcg tablet was 6.75 times more expensive as of 2020 than the lozenge.[21][22] In 2017, it was the 250th most commonly prescribed medication in the United States, with more than 1.7 million prescriptions.[23][24]

References[edit]

  1. ^ Bonewit-West, Kathy; Hunt, Sue A.; Applegate, Edith (2012). Today's Medical Assistant: Clinical and Administrative Procedures. Elsevier Health Sciences. p. 571. ISBN 9781455701506. Archived from the original on 2020-07-28. Retrieved 2020-08-06.
  2. ^ a b Clinically Oriented Pharmacology (2 ed.). Quick Review of Pharmacology. 2010. p. 172.
  3. ^ a b c d e f g h i j "Fentanyl, Fentanyl Citrate, Fentanyl Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 14 December 2017. Retrieved 8 December 2017.
  4. ^ "Guideline for administration of fentanyl for pain relief in labour" (PDF). RCP. Archived (PDF) from the original on 4 March 2016. Retrieved 7 October 2015. Onset of action after IV administration of Fentanyl is 3–5 minutes; duration of action is 30–60 minutes.
  5. ^ a b "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 25 July 2020. Retrieved 9 September 2020.
  6. ^ "Interpreting Urine Drug Tests (UDT)". Archived from the original on 25 October 2023. Retrieved 24 October 2023.
  7. ^ "Fentanyl Drug Overdose". CDC Injury Center. 29 August 2017. Archived from the original on 15 December 2017. Retrieved 14 December 2017.
  8. ^ "tablets". Archived from the original on 2020-07-31.
  9. ^ a b "Fentanyl Side Effects in Detail - Drugs.com". Drugs.com. Archived from the original on 2018-06-16. Retrieved 2018-06-16.
  10. ^ "Commission on Narcotic Drugs takes decisive step to help prevent deadly fentanyl overdoses". Commission on Narcotic Drugs, United Nations Office on Drugs and Crime. 16 March 2017. Archived from the original on 20 March 2017. Retrieved 19 March 2017.
  11. ^ Stanley TH (April 1992). "The history and development of the fentanyl series". Journal of Pain and Symptom Management. 7 (3 Suppl): S3-7. doi:10.1016/0885-3924(92)90047-L. PMID 1517629.
  12. ^ Narcotic Drugs Estimated World Requirements for 2017 Statistics for 2015 (PDF). New York: United Nations. 2016. p. 40. ISBN 978-92-1-048163-2. Archived (PDF) from the original on 22 October 2017. Retrieved 14 December 2017.
  13. ^ "Fentanyl And Analogues". LverTox. 16 October 2017. Archived from the original on 7 January 2017. Retrieved 14 December 2017.
  14. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  15. ^ "Overdose Death Rates". National Institute on Drug Abuse. 15 September 2017. Archived from the original on 13 December 2017. Retrieved 14 December 2017.
  16. ^ "Nearly half of opioid-related overdose deaths involve fentanyl". National Institute on Drug Abuse. 2018-05-01. Archived from the original on 2018-06-14. Retrieved 2018-06-14.
  17. ^ Hedegaard H, Bastian BA, Trinidad JP, Spencer M, Warner M (December 2018). "Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011-2016". National Vital Statistics Reports. 67 (9): 1–14. PMID 30707673.
  18. ^ "Fentanyl Drug Overdose". CDC. 21 December 2018. Archived from the original on 15 December 2017. Retrieved 28 April 2019.
  19. ^ "Single Drug Information". International Medical Products Price Guide. Archived from the original on 15 December 2017. Retrieved 14 December 2017.
  20. ^ "NADAC as of 2017-12-13". Centers for Medicare and Medicaid Services. Archived from the original on 14 December 2017. Retrieved 14 December 2017.
  21. ^ "Fentanyl Buccal". Archived from the original on 2020-07-31.
  22. ^ "Fentanyl Citrate Generic Actiq". GoodRx. Archived from the original on 31 July 2020. Retrieved 27 May 2020.
  23. ^ "The Top 300 of 2020". ClinCalc. Archived from the original on 12 February 2021. Retrieved 29 April 2020.
  24. ^ "Fentanyl - Drug Usage Statistics". ClinCalc. Archived from the original on 11 April 2020. Retrieved 29 April 2020.
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