Fentanyl (Sublimaze): Elite Nursing 80/20 Summary

1. ID & Action: Phenylpiperidine synthetic opioid agonist. Binds mu/kappa receptors. Inhibits adenylyl cyclase, decreasing cAMP to block release of neurotransmitters (substance P, GABA, dopamine, acetylcholine, norepinephrine). Highly lipophilic (580:1 vs. morphine); rapid onset. 2. Therapeutic Use: General/spinal anesthesia adjunct; chronic and breakthrough pain (transmucosal/nasal only). 3. 80/20 Formulations (NOT Interchangeable mcg-to-mcg):

• IV/IM: Peak IV analgesia in minutes. Inject slowly over 1–3 min; rapid injection can cause apnea or chest wall rigidity.
• Transdermal Patch: Onset 12–24h; changed every 72h. Epidermal depot slowly absorbs. Critical: Avoi ...