Fentanyl interaction

Mercadante S, Villari P, Ferrera P. Itraconazole-fentanyl interaction in a cancer patient. J Pain Symptom Manage 2002 24(3) 284-6. 

Fentanyl interacts predominantly with the mu receptors in the brain and spinal cord to produce analgesia, euphoria, and dysphoria [1,2]. Because of its low... 

Labroo, R. B., Paine, M. F., Thummel, K. E., Kharasch, E. D., Fentanyl metabolism by human hepatic and intestinal cytochrome P4503A4. Implications for interindividual variability in disposition, efficacy and drug interactions, Drug Metab. Disp. 1997, 25, 1072-1080. 

Drugs that may affect amiodarone include hydantoins, cholestyramine, fluoroquinolones, rifamycins, ritonavir, and cimetidine. Drugs that may be affected by amiodarone include anticoagulants, beta-blockers, calcium channel blockers, cyclosporine, dextromethorphan, digoxin, disopyramide, fentanyl, flecainide, hydantoins, lidocaine, methotrexate, procainamide, quinidine, and theophylline. Drug/Lab test interactions Amiodarone alters the results of thyroid function tests, causing an increase in serum T4 and serum reverse T3 levels and a decline in... 

Uses HTN, stable or unstable angina Action CCB relaxes coronary vascular smooth muscle Dose 2.5-10 mg/d PO -1- w/ h atic impair Caution [C, ] Disp Tabs SE Peripheral edema, HA, palpitations, flushing Interactions t Effect of hypotension M7 antih5rpCTtensives, fentanyl, nitrates, quinidine, EtOH, grapefruit juice t risk of neurotox W/Li -1- effects W/ NSAIDs EMS Concurrent EtOH and... 

Uses Obesity Action Blocks uptake of norepinephrine, serotonin, dopamine Dose 10 mg/d PO, may to 5 mg after 4 wk Caution [C, -] w/ SSRIs, Li, dextromethorphan, opioids Contra MAOI w/in 14 d, uncontrolled HTN, arrhythmias Disp Caps SE HA, insomnia, xerostomia, constipation, rhinitis, tach, HTN Interactions T Risk of serotonin synd W/ dextromethorphan, ergots, fentanyl, Li, meperidine, MAOIs, naratriptan, pentazocine, rizatriptan, sumatriptan, SSRIs, tryptophan, zolmitriptan, St. John s wort effects W/ cimetidine, erythromycin, ketoconazole T CNS depression W/ EtOH EMS Use fentanyl w/ caution, may T risk of serotonin synd concurrent EtOH use can T CNS depression OD May cause tach, HTN, diaphoresis, HA, fever, agitation, muscle tremors, and Szs symptomatic and supportive... 

WARNING Exacerbation of ischemic heart Dz w/ abrupt D/C Uses HTN MI Action p-Adrenergic receptor blocker, pj, P2 Dose HTN 10-20 mg bid, up to 60 mg/d MI 10 mg bid Caution [C (1st tri D if 2nd or 3rd tri), +] Contra CHF, cardiogenic shock, bradycardia, heart block, COPD, asthma Disp Tabs SE Sexual dysfxn, arrhythmia, dizziness, fatigue, CHF Interactions t Effects W/ antihyper-tensives, ciprofloxacin, fentanyl, nitrates, quinidine, res pine t bradycardia and... 

Tranquilizer, sedation, antiemetic Dose Adults. N Initial max 2.5 mg IV/EM, may repeat 1.25 mg based on response Premed 2.5-10 mg IV, 30-60 min preop Peds. Premed 0.1-0.15 mg/kg/dose Caution [C, ] Contra Component sensitivity Disp Inj SE Drowsiness, i BP, occasional tach extrapyramidal Rxns, T QT interval, arrhythmias Interactions T Effects W/ CNS depressants, fentanyl, EtOH T hypotension W/ antihypertensives, nitrates EMS Monitor ECG, may T QT interval epi may cause paradoxical hypotension, do not use fentanyl may cause HTN, do not use if possible use caution w/ analgesics and opioids may T CNS depression monitor for S/Sxs of extrapyramidal Rxns which can be treated w/ Benadryl concurrent EtOH use can T CNS depression OD May cause T of nl SEs symptomatic and supportive... 

CCB Dose 10-60 mg/d PO 4- start doses w/ elderly or hepatic impair Caution [C, ] Disp Tabs SE Edema, HA, flushing Interactions T Effects W/ antihypertensives, cimetidine, nitrates, EtOH, high-fat foods 4- effects W/ phenytoin, St. John s wort EMS T Adverse effects w/ grapefruit juice and EtOH use fentanyl and nitro w/ caution T risk of photosensitivity Rxn OD May cause hypotension, tach, and CV collapse calcium salts can be given as antidote... 

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