Ziconotide neither interacts with opiate receptors nor potentiates opiate-induced respiratory depression. However, comparisons were made using a single convenient dose rather than equipotent doses, and dose—response studies were indicated to determine optimum dosages. Use maintenance doses of 0. In a recent publication from our department, propofol 2. If verapamil 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. Moderate Additive drowsiness may occur if cetirizine or levocetirizine is administered with other drugs that depress the CNS, including opiate agonists. If crizotinib is discontinued, consider increasing the alfentanil dose until stable drug effects are achieved and monitor for evidence of opioid withdrawal.
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When used as part of anesthesia, opiate agonists provide analgesic protection against hemodynamic responses to surgical stress by attenuating the catecholamine response.
Practical aspects of alfentanil infusion.
If concurrent use is imperative, reduce the dose of one or both drugs if clinically indicated. Although commonly used together for additive analgesic effects, the patient must be monitored for respiratory depression, hypotension, and excessive sedation due to additive effects on the CNS and blood pressure.
Major Alfentanil belongs to the phenylpiperidine group of opioids. Treatment with alfentanil may be initiated no sooner than 1 week after completion of conivaptan therapy. Caution is advised until more data are available.
Moderate Consider a reduced dose of alfentanil with frequent monitoring for respiratory depression and sedation if concurrent use of itraconazole is necessary. Postmarketing reports of interactions with concomitant use have been noted. If verapamil is discontinued, alfentwnil 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.
Alfentanil belongs to the same group of opiate agonists, phenylpiperidines, as meperidine, a known serotonin reuptake inhibitor. Alfentanil is a substrate for the cytochrome CYP 3A4 isoenzyme.
The patient should be observed for symptoms resembling neuroleptic malignant syndrome, and the usual regimen should be administered as soon as the patient is able to take oral medication. Major Concomitant use of alfentanil with other CNS depressants can potentiate the effects of alfentanil on respiration, CNS depression, sedation, and hypotension. Alfentanil is a CYP3A4 substrate. Also, patients should be opiate-free for at least days prior to initiating naltrexone therapy.
Moderate Loxapine can potentiate the actions of other CNS depressants such as opiate agonists. As a result, the risk of prolonged or delayed respiratory depression may be increased. Moderate Drugs that can cause CNS depression such as opiate agonists, if used concomitantly with paliperidone, can increase both the frequency and the alfentajil of adverse effects such as drowsiness, sedation, and dizziness.
Moderate Pain medications that contain opiate agonists may intensify CNS depressive adverse effects seen with gabapentin use, such as drowsiness or dizziness. The manufacturer states that alfentanil use with MAOIs has resulted in rare reports of serious untoward reactions.
These symptoms could be troublesome in patients with cardiac disease e. Moderate Opiate agonists may potentiate orthostatic hypotension when used concurrently with thiazide diuretics. At serum concentrations of 0. These drugs used in combination may result in elevated alfentanil plasma concentrations, causing an increased risk for alfentanil-related adverse events.
In Hong Kong, propofol coadministered with an opiate, such as morphine or fentanyl, is the usual preference. Alfentanil infusions should be discontinued at least 10—15 minutes prior to the end of surgery.
Scottish Palliative Care Guidelines – Alfentanil
If carbamazepine is discontinued, consider a dose reduction of alfentanil and frequently monitor for signs or respiratory depression and sedation.
This interaction is most likely to occur if palbociclib is added after a stable dose of alfentanil is achieved. Moderate Opiate agonists antagonize GI motility and can decrease the gastroprokinetic effects of metoclopramide. Epidural Administration This route of administration should only be used by specially trained health care professionals.
Seventy-five ethnic Chinese patients were recruited, five groups of 15 patients.
Practical aspects of alfentanil infusion.
The clinical relevance of the in vivo effect of encorafenib on CYP3A4 a,fentanil not established. Moderate Octreotide can cause additive constipation with opiate agonists such as alfentanil. Monitor for decreased efficacy of alfentanil during coadministration.
Examples of drugs associated with CNS depression include pregabalin. Minor Alfentanil is an inhibitor of P-glycoprotein Pgp.