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Alfentanil is a potent, short-acting opioid analgesic that is useful in palliative care, particularly in scenarios where other opioids like morphine or diamorphine may not be suitable.
| Aspect | Details about Alfentanil |
|---|---|
| Classification | Short-acting opioid anaesthetic and analgesic, derivative of fentanyl. |
| Mechanism of Action | Primarily binds to the mu-opioid receptor, mimicking the actions of morphine. Induces anti-nociception by inhibiting the release of neurotransmitters like substance P, GABA, dopamine, acetylcholine, and noradrenaline. Also inhibits the release of vasopressin, somatostatin, insulin, and glucagon. |
| Clinical Use | • Anesthetic during surgery. • Supplemental analgesia during surgical procedures. • Analgesic for critically ill patients. |
| Efficacy | Produces an early peak analgesic effect and allows fast recovery of consciousness. |
| Use in Renal Impairment | An alternative Continuous Subcutaneous Infusion (CSCI) delivered opioid for patients who are unable to tolerate morphine or diamorphine, e.g., in cases of renal impairment. |
| Dosage Equivalence | • Subcutaneous (SC) Alfentanil 1mg is equivalent to = SC diamorphine 10mg = SC morphine 15mg. |
| Suitability for Breakthrough Pain | Not suitable for breakthrough pain due to its short-acting nature. |
References
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