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μννλμ ννλκ³Ό ꡬ쑰μ μΌλ‘ μ μ¬ν νλνΌν리λ κ³μ΄μ **κ°λ ₯νκ³ μν¨μ±μΈ ν©μ± μνΈμμ **μ λλ€. μ£Όμ νΉμ§μ λ€μκ³Ό κ°μ΅λλ€: * **λΉ λ₯Έ λ°ν λ° μ§§μ μμ© μκ°:** μ§μ©μ±μ΄ λμ νμ‘-λ μ₯λ²½μ λΉ λ₯΄κ² ν΅κ³Όνλ―λ‘ μ§§μ μμ μ΄λ μ§μμ μ λ§₯ μ£Όμ (CRI)μ μ΄μμ μ λλ€. * **λ§μ·¨ 보쑰μ :** μ£Όλ‘ κ°λ ₯ν μ§ν΅ μμ©μ μ 곡νκ³ μ λ λλ μ μ§ λ§μ·¨μ (μ: νλ‘ν¬ν΄, μ΄μν루λ)μ μꡬ μ©λμ μ€μ΄λ λ° μ¬μ©λ©λλ€. * **μ’ νΉμ΄μ±:** μμνμ μ¬μ© κ²½νμ ννλμ λΉν΄ λ€μ μ νμ μ΄μ§λ§, νΉν κ³ μμ΄μ λ§μ·¨ μ€ λ³΄μ‘° μλ²μΌλ‘ μ μ©ν κ²μΌλ‘ μλ €μ Έ μμ΅λλ€. * **κ·μ μν:** λ¨μ© κ°λ₯μ±μ΄ λμ **2κΈ ν΅μ μ½λ¬Ό(Class-II)**λ‘ λΆλ₯λ©λλ€.
μμ© κΈ°μ : Alfentanil acts primarily as a potent and highly selective agonist at **mu (ΞΌ) opioid receptors** in the central nervous system. * **Mechanism:** Binds to pre- and post-synaptic **ΞΌ-receptors** β inhibits adenylate cyclase β decreases intracellular cAMP β promotes opening of inward-rectifying potassium channels β hyperpolarization of the neuron. * **Neurotransmitter Inhibition:** Concurrently inhibits voltage-gated calcium channels β decreases the release of excitatory nociceptive neurotransmitters (such as **substance P** and **glutamate**) β profound analgesia and sedation. * **Systemic Effects:** Causes dose-dependent respiratory depression by decreasing the responsiveness of the brainstem respiratory centers to carbon dioxide.
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- As a premed Β· 5 micrograms/kg alfentanil with 0.3-0.6 mg of atropine Β· IV Β· 30 seconds before injecting propofol Β· Can reduce the dose of propofol needed to induce anesthesia to 2 mg/kg, but apnea may still occur.
- As a constant rate infusion for pain Β· Loading dose of 0.5-1 micrograms/kg, then a CRI of 0.5-1 micrograms/kg per minute. Β· IV Β· CRI
- As an analgesic supplement to anesthesia Β· 2-5 micrograms/kg Β· IV Β· q20 minutes
- For intra-operative analgesia in patients with intracranial disease Β· 0.2 micrograms/kg/minute Β· IV Β· CRI
- Intraoperative analgesia Β· 0.001-0.005 mg/kg Β· IV Β· single bolus Β· Administer slowly to avoid severe bradycardia
- Intraoperative analgesia Β· 0.001-0.0025 mg/kg/min Β· IV Β· continuous rate infusion Β· Best method of administration due to short duration of action
- Intraoperative analgesia Β· 0.001 mg/kg Β· IV Β· single bolus Β· Administer slowly to avoid severe bradycardia
- Intraoperative analgesia Β· 0.001 mg/kg/min Β· IV Β· continuous rate infusion Β· Best method of administration due to short duration of action
μ©λμ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μ°Έκ³ μλ£μ λλ€. νμ μ΅μ λΌλ²¨κ³Ό κ°λ³ νμμ λν΄ νμΈνμμμ€.
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- Patients hypersensitive to opioids
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- Dose-related respiratory depression
- Bradycardia
- CNS depression
- Dose-related skeletal muscle rigidity
- Asystole (rare)
- Hypercarbia (rare)
- Hypersensitivity reactions (rare)
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- CYP3A4 Inhibitors (erythromycin, cimetidine, ketoconazole, itraconazole, fluconazole, diltiazem) Β· May increase the half-life and decrease the clearance of alfentanil leading to prolonged effect and an increased risk of respiratory depression
- Beta-blockers Β· May produce bradycardia or hypotension if used concurrently with alfentanil
- Other anesthetic agents Β· May produce bradycardia or hypotension; respiratory or CNS depression may be exacerbated
- Inhaled anaesthetics Β· Reduces the dose requirements of concurrently administered anaesthetics by at least 50% Β· major
- Monoamine oxidase inhibitors (MAOIs) Β· Risk of serotonin toxicity Β· major
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- Anesthetic and/or analgesic efficacy
- Cardiac rate and rhythm
- Respiratory rate and depth
- Pulse oximetry or other methods to measure blood oxygenation
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### Signs of Toxicity * **Severe IV Overdose:** Circulatory collapse, pulmonary edema, seizures, cardiac arrest, and death. * **Less Severe Overdose:** CNS and respiratory depression, coma, hypotension, muscle flaccidity, and miosis. ### Treatment * **Supportive Care:** Provide cardiovascular and respiratory support (e.g., mechanical ventilation, IV fluids) as necessary. * **Antidote:** Administration of an opiate antagonist such as **naloxone**. Although alfentanil has a relatively rapid half-life, multiple doses of naloxone may be necessary. > **Measurement Precaution:** Because of the drug's extreme potency, the use of a tuberculin syringe to measure dosages less than 1 mL, along with a dosage calculation and measurement double-check system, is strongly recommended.
VetSheet μ½λ¬Ό λ νΌλ°μ€λ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μμ¬κ²°μ 보쑰 λꡬμ΄λ©°, μ λ¬Έμ νλ¨μ΄λ μ μ‘°μ¬μ μ΅μ λΌλ²¨μ λμ νμ§ μμ΅λλ€.