Alfentanil

Structural formula
General
Non-proprietary name	Alfentanil
other names	N - [1- [2- (4-ethyl-5-oxo-1,4-dihydrotetrazol-1-yl) ethyl] -4- (methoxymethyl) -4-piperidyl] - N -phenyl-propanamide
Molecular formula	C 21 H 32 N 6 O 3
External identifiers / databases
PubChem	51263
DrugBank	DB00802
Wikidata	Q176533
Drug information
ATC code	N01 AH02
Drug class	Opioid
properties
Molar mass	416.52 g mol −1
Physical state	firmly
Melting point	138.4 ° C , also 140.8 ° C stated ( hydrochloride monohydrate)
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
H and P phrases	H: 225-301 + 311 + 331-370
	P: 210-280-302 + 352-312-304 + 340 + 312-370 + 378-403 + 235
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Alfentanil (trade names Rapifen , Alfenta ) is a synthetic opioid that is used almost exclusively for anesthesia . The active ingredient was patented by Janssen Pharmaceutica in 1978 and is used as hydrochloride monohydrate. Side effects and interactions are practically the same as with the related fentanyl . Compared to fentanyl, alfentanil has a faster onset of action and a shorter duration of action. Alfentanil is subject to the Narcotics Prescription Regulation .

Clinical information

Alfentanil is used as an opioid in anesthesia, especially for short surgical interventions (e.g. scraping or repositioning). The average dosage of the injection solution is 15–30 µg / kg body weight i.a. v., in a patient weighing 70 kg, about 1–2 mg. The duration of action is about 10 to 15 minutes. Depending on the dose, the respiratory depressive effect can last longer after operations.

The side effects are the same as for the other opioids . Typical for alfentanil is the occurrence of thoracic rigidity (rigidity of the chest due to rigidity of the skeletal muscles), which occurs in up to 10% of patients.

Pharmacological properties

The relative analgesic potency of alfentanil is 30–40 compared to morphine , or about 0.3 compared to fentanyl . Alfentanil is a pure agonist at µ-receptors. The volume of distribution of alfentanil is only 0.06 l / kg body weight. When administered intravenously, the maximum effect is achieved after about one minute. In comparison to fentanyl, alfentanil shows only a slight increase in the half-life even with repeated or continuous administration. Alfentanil is broken down in the liver, with no active metabolites being formed.

Trade names

Rapifen (D, A, CH), generic (D)

literature

Larsen Anesthesia (5th Edition)
Technical information Rapifen ^®

Individual evidence

↑ ^a ^b entry on alfentanil. In: Römpp Online . Georg Thieme Verlag, accessed on April 7, 2016.
↑ ^a ^b Datasheet Alfentanil hydrochloride solution 1.0 mg / mL in methanol (as free base) from Sigma-Aldrich , accessed on October 24, 2016 ( PDF ).
↑ Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 32.
↑ ROTE LISTE 2017, Verlag Rote Liste Service GmbH, Frankfurt am Main, ISBN 978-3-946057-10-9 , p. 159.

[Römpp-1] try on alfentanil. In: Römpp Online . Georg Thieme Verlag, accessed on April 7, 2016.

[Sigma-2] Datasheet Alfentanil hydrochloride solution 1.0 mg / mL in methanol (as free base) from Sigma-Aldrich , accessed on October 24, 2016 ( PDF ).

[3] Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 32.

[ROTE_LISTE-4] ROTE LISTE 2017, Verlag Rote Liste Service GmbH, Frankfurt am Main, ISBN 978-3-946057-10-9 , p. 159.