Sublimax Injection Special Precautions

Impaired respiration: Fentanyl should be used with caution in patients with severe impairment of pulmonary function because of the possibility of respiratory depression (e.g. chronic obstructive pulmonary disease, patients with decreased respiratory reserve, or any patient with potentially compromised respiration). In such patients, narcotics may further decrease respiratory drive and increase airway resistance. During anaesthesia, this can be managed by assisted or controlled respiration.
Narcotic antagonists for respiratory depression: Respiratory depression caused by narcotic analgesics can be reversed by narcotic antagonists. However, appropriate surveillance should be maintained because the duration of respiratory depression of dose of Fentanyl employed during anaesthesia is usually longer than the duration of narcotic antagonist action.
Impaired liver kidney function: Fentanyl should be administered with caution to patients with liver and kidney dysfunction because of the importance of these organs in the metabolism and excretion of drugs.
Bradycardia: Fentanyl may produce bradycardia, which may be treated with atropine; however it should be used with caution in patients with cardiac bradyarrythmias.
Sphincter of Oddi Spasm: As observed with all narcotic analgesics, episodes suggestive of sphincter of Oddi Spasm may occur with Fentanyl.
Adjunct to conduction anaesthesia: Nitrous oxide has been reported to produce cardiovascular depression when given with high doses of Fentanyl. Certain forms of conduction anaesthesia, such as spinal anaesthesia and some peridural anaesthetics, can alter respiration by blocking intercostals nerves. Through other mechanisms Fentanyl can also alter respiration.
Neuroleptics (i.e. droperidol): Blood pressure may be altered and hypotension can occur.