sufentanil (Sufenta,Dsuvia)
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Introduction
Tradename: Sufenta. DEA-controlled substance: class 2.
Indications
- analgesic component of monitored/general anesthesia
Contraindications
concurrent use of MAO inhibitors
Dosage
- initial dose: 1-8 ug/kg
- maintenance: 10-50 ug IV
- epidural: 25-50 ug
- sublingual (Dsuvia) 30 ug
Injection: 50 ug/mL (1 mL, 2 mL, 5 mL).
Pharmacokinetics
- rapid onset of action (1-3 minutes)
- duration of action 45-90 minutes
- metabolized by the liver by cyt P450 3A4
- eliminated mostly as inactive drug in the urine
- triphasic elimination
- terminal 1/2life of 2-2.5 hours
elimination via liver
1/2life = 2-2.5 hours
Adverse effects
- common (> 10%)
- less common (1-10%)
- uncommon (< 1%)
- circulatory depression, convulsions, dysesthesia, paradoxical CNS excitement, delirium, mental depression, dizziness, rash, urticaria, itching, urinary tract spasm, laryngospasm, bronchospasm, cold, clammy skin, addiction with prolonged use
- other
- headache
- shivering
- constipation
- muscle rigidity (dose-related)
- overdose:
- drug adverse effects of opiates
- drug adverse effects of psychotropic agents
- drug adverse effects of sedatives
Drug interactions
- benzodiazepines, barbiturates, alcohol: in combination increase CNS adverse effects
- MAO inhibitors: in combination is contraindicated; fatal reactions have occurred
- naloxone: direct opiate antagonist
- scorpion venom: in combination decreases toxic effects of the venom
- any drug that inhibits cyt P450 3A4 may increase levels of sufentanil
- any drug that induces cyt P450 3A4 may diminish levels of sufentanil
- drug interaction(s) of benzodiazepine with opiates
- drug interaction(s) of Z-drugs with opiates
- drug interaction(s) of alcoholic beverage with opiates
- drug interaction(s) of pregabalin with opiates
- drug interaction(s) of gabapentin with opiates
Mechanism of action
- opiate agonist
- phenenylpiperidine derivative
More general terms
Additional terms
Component of
- citrate/ropivacaine/sufentanil
- bupivacaine/sufentanil
- bupivacaine/citrate/sufentanil
- ropivacaine/sufentanil
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Prescriber's Letter 13(3): 2006 Cytochrome P450 drug interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220233&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Brooks M FDA Goes Ahead With Approval of Sufentanil Despite Controversy. Medscape - Nov 02, 2018. https://www.medscape.com/viewarticle/904330
FDA Statement. Nove 2, 2018 Statement from FDA Commissioner Scott Gottlieb, M.D., on agency's Dsuvia and the FDA's future consideration of new opioids. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm624968.htm
FDA ADVISORY COMMITTEE BRIEFING DOCUMENT DSUVIA <TM> (sufentanil) sublingual tablet, 30 mcg AcelRx Briefing Document. FDA Advisory Committee Meeting Nov, 2018 https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndAnalgesicDrugProductsAdvisoryCommittee/UCM622858.pdf