Narcotics

• Fentanyl is a potent synthetic narcotic analgesic
• - more rapid and less prolonged action

Induce sedation for endotracheal intubation

• 1. MAO inhibitors within 14days
• 2. Myasthenia gravis

• 1. Increased intracranial pressure (ICP)
• 2. COPD
• 3. Respiratory problems
• 4. Hepatic & renal insufficiency
• 5. elderly
• 6. debilitated

25-100 mcg slowly IV (2-3min)

Morphine sulfate is a potent analgesic and sedative that causes some vasodilation, reducing venous return, and reduced myocardial oxygen demand

• 1. Moderate to severe pain
• 2. MI
• 3. to reduce venous return in pulmonary edema

• 1. Hypersensitivity to opiates
• 2. Undiagnosed head or abdominal injury
• 3. Hypotension
• 4. Volume depletion
• 5. Acute bronchial asthma
• 6. COPD
• 7. Severe respiratory depression
• 8. Pulmonary edema due to chemical inhalation

• - Elderly, children, debilitated patients.
• - Naloxone (Narcan) should be readily available to counteract the effects of morphine

Pain : 2.5-15mg IV; 5-20mg IM/Subcutaneous

AMI/PE : 1-2mg/6-10 min to response

Naloxone is a pure narcotic antagonist that blocks the effects of both natural and synthetic narcotics and may reverse respiratory depression

• 1. Narcotic and synthetic narcotic overdose
• 2. Coma of unknown origin

• 1. Hypersensitivity to the drug
• 2. Non-narcotic induced respiratory depression

• - Possible dependency
• - Half life that is shorter than that of most narcotics, patient may return to OD state

0.4-2 mg IV/IM (2-2.5X dose ETT), repeated every 2-3mins as needed up to 10mg