Moderate Frequently monitor for respiratory depression and sedation if concurrent use of everolimus with alfentanil is necessary; consider a reduced dose of alfentanil if clinically appropriate. Due to the effects of opiate agonists on the gastrointestinal tract, alfentanil should be used cautiously in patients with GI disease including GI obstruction or ileus, ulcerative colitis, or pre-existing constipation. If apalutamide is discontinued, consider reducing the alfentanil dosage and monitor for evidence of respiratory depression. Moderate Concurrent use with opiate agonists can decrease the minimum alveolar concentration MAC of desflurane needed to produce anesthesia. Severe and unpredictable potentiation of MAOIs has been reported rarely with alfentanil. Moderate Monitor for alfentanil toxicities that may require alfentanil dose reduction if given concurrently with fostamatinib.
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Alfentanil should only be administered by health care professionals trained in anesthesiology and the management of pain and who are familiar with the respiratory effects of strong opiate agonists.
Buprenorphine may cause withdrawal symptoms in patients receiving chronic opiate agonists as well as possibly potentiate CNS, alfenntanil, and hypotensive effects. Minor Theoretically, apraclonidine might potentiate the effects of CNS depressant drugs such as opiate agonists.
Practical aspects of alfentanil infusion.
These events are associated with opiate-induced lowering of mean arterial pressure, which stimulates a regulatory response to increase cerebral blood flow leading to increased ICP.
Major Concomitant use of tramadol increases the seizure risk in patients taking opiate agonists. Moderate Consider an increased dose of alfentanil and monitor for evidence sringe opioid withdrawal if coadministration with enzalutamide is necessary.
Moderate Bethanechol facilitates intestinal and bladder function via parasympathomimetic actions. Bladder obstruction, hepatic disease, oliguria, prostatic hypertrophy, renal disease, renal impairment, urethral stricture, urinary retention. Moderate Monitor patients for bradycardia and hypotension when alfentanil is coadministered with clevidipine.
Patients with chronic liver or renal impairment may require less syrine dosing intervals due to decreases in alfentanil protein binding.
Moderate Concomitant use of alfentanil with other CNS depressants, such as sedating H1 blockers can potentiate the effects of alfentanil on respiration, alertness, and blood pressure. The significance or effect of this interaction is not known; however, elevated concentrations of the opiate agonist is possible.
May be given as an intermittent bolus syringge continuous infusion. Continuous infusions longer aflentanil 5 days have not been studied. Moderate Carefully consider the need for concomitant treatment with opioid agonists and amifampridine, as coadministration may increase the risk of seizures.
Management of respiratory depression may include close observation, supportive measures, and use of an opioid antagonist. Due to the extremely long half-life of amiodarone, a drug interaction is possible for days to weeks after amiodarone discontinuation.
Monitor for signs of opioid withdrawal. Moderate Drugs that can cause CNS depression, if used concomitantly with asenapine, may increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, and dizziness. Methyldopa xyringe potentiate the effects of CNS depressants, such as opiate agonists, when administered concomitantly.
Caution should be exercised with simultaneous use of these agents due to potential excessive CNS effects. Alfentanil is administered intravenously and should only be given by individuals trained in the administration of general anesthetics and the management of the respiratory effects of potent opioids.
Caution should be exercised when using these agents concurrently. Concentrations in milk were about the same as pre-surgery 28 hours after the last dose. alfentsnil
Practical aspects of alfentanil infusion.
Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Monitor for decreased efficacy of alfentanil during coadministration. Because it is an opioid analgesic, alfentanil may cause respiratory depression in the newborn if used close to delivery. If rucaparib is discontinued, alfentanil plasma concentrations will decrease resulting in reduced efficacy of the opioid and potential withdrawal syndrome in a patient who has developed physical dependence to alfentanil.
Opiate agonists may obscure the diagnosis or clinical course in patients with acute abdominal conditions. The laryngeal mask airway: An alfentanil dosage adjustment may be necessary.
Scottish Palliative Care Guidelines – Alfentanil
If alfentanil is used concurrently with morphine, monitor patients for sedation and respiratory depression. Concomitant administration of apomorphine and CNS depressants could result in additive depressant effects.
Repeated-measures analysis of variance was used to determine the mean odse pressure Alfnetanil and heart rate over time baseline, after induction, after cLMA insertion adjusted for sex. However, the dose of alfentanil significantly affected the duration of apnea, which can be a nuisance in the anesthetized patient when spontaneous ventilation is planned.