Dosing and uses of Sufenta (sufentanil)
Adult dosage forms and strengths
injectable solution: Schedule II
- 0.05mg/mL
Anesthesia
Induction/intubation: 1-2 mcg/kg IV, THEN 10-50 mcg IV PRn
General Anesthesia: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRn
Should be administered with 100% O2, with ventilatory support
Dose should be calculated based on ideal body weight
Other Indications & Uses
Low dose: Analgesia in intubation, ventilation (adjunct)
High dose: Primary anesthesia induction & maint
Epidural analgesia (with bupivacaine)
Pediatric dosage forms and strengths
injectable solution: Schedule II
- 0.05mg/mL
Anesthesia
<2 years: Safety and efficacy not established
2-12 years: 10-25 mcg/kg IV increments
>12 years: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRn
Geriatric dosage forms and strengths
Anesthesia
Induction/intubation: 1-2 mcg/kg IV, THEN 10-50 mcg IV PRn
General Anesthesia: 8-30 mcg/kg IV, THEN 25-30 mcg IV PRn
Should be administered with 100% O2, with ventilatory support
Dose should be calculated based on ideal body weight
Sufenta (sufentanil) adverse (side) effects
Frequency not defined
Nausea
Vomiting
Constipation
Sweating, flushing, warmness of the face/neck/upper thorax
Pruritus, urticaria
Bradycardia
Dizziness
Visual disturbances
Mentalclouding/depression
Sedation
Coma
Euphoria/Dysphoria
Weakness
Faintness
Agitation
Restlessness
Nervousness
Seizures
Anticholinergic effects (dry mouth, palpitation, tachycardia)
Respiratory/circulatory depression
Respiratory arrest, shock, cardiac arrest
QT-interval prolongation, severe cardiac arrhythmias, cardiac arrest, ST segment elevation, ventricular tachycardia
Myocardial infarction, angina pectoris, syncope
Urinary retention, oliguria
Warnings
Contraindications
Relative: hepatic function impairment
Cautions
Bradycardia, compromised cardiac reserve, head injury, hypothyroidism, increased intracranial pressure, intracranial lesions, renal function impairment, respiratory impairment
Concurrent administration of benzodiazepine or neuromuscular blocker will decrease chest wall rigidity
Pregnancy and lactation
Pregnancy category: C
Lactation: not known if excreted in breast milk
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Sufenta (sufentanil)
Mechanism of action
May open K+ channels and inhibit Ca++ channels, causing an increase in pain threshold and alteration in pain perception. It also inhibits ascending pain pathways
Pharmacokinetics
Half-life: 5-10hr (neonates); 55-139 min (infants and children); 164 min (adults)
Onset: 1-3 min (IV); 10 min (epidural)
Duration: 2.3-3.8 hr
Peak Plasma: 36-43 ng/mL
Protein Bound: 93% (adults); 79% (neonates)
Vd: 2.48 L/kg
Metabolism: hepatic P450 enzyme CYP3A4; (N-dealkylation, O-demethylation)
Excretion: Urine (primarily)
Administration
IV Compatibilities
Solution: D5W, NS (5 mg/L)
Additive: bupivacaine, ropivacaine
Syringe: atracurium, atropine, dexamethasone, diphenhydramine, haloperidol, hydroxyzine, ketorolac, methotrimeprazine, metoclopramide, midazolam, prochlorperazine, scopolamine
Y-site: ampho B chol SO4, atropine, bivalirudin, ceftazidime, cisatracurium, dexamethasone, dexmedetomidine, diazepam, diphenhydramine, etomidate, fenoldopam, gatifloxacin, haloperidol, Hextend, hydroxyzine, ketorolac, linezolid, methotrimeprazine, metoclopramide, midazolam, phenobarbital, prochlorperazine, propofol, remifentanil, scopolamine
IV Incompatibilities
Solution: NS (20 mg/L)
Syringe: diazepam, lorazepam, phenobarbital, phenytoin
Y-site: lorazepam, phenytoin, thiopentaL
IV Administration
Administer by IV injection or epidural injection
Has also been administered by IM injection or by intermittent IV infusion
Storage
Protect from light
Store at 15-25°C
