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FENTANYL WHAT IS IT? Fentanyl can be found in prescription form, introduced to the medical community in the 1960s Fentanyl analogues are now being Fentanyl is a potent synthetic and prescribed to relieve severe pain post-surgery created in clandestine laboratories to opioid analgesic, 50 to 100x or during end-of-life care . In its prescription form, be sold and used illegally. In it's non- more powerful than fentanyl is sold under the brand names Actiq®, prescription form, fentanyl is found in morphine. Duragesic®, and Sublimaze®. When prescribed by a powder form, spiked on blotter paper; physician, fentanyl is often administered via mixed with heroin; or as tablets that injection, transdermal patch, or in lozenges. attempt to mimic other opioids. Effects: Like other opioids, Fentanyl binds to Through Fentanyl's effects on the Euphoria, relaxation, drowsiness, opioid receptors in the reward centers opioid receptors in the brain stem nausea, confusion, constipation, of the brain, increasing dopamine however, it can inhibit normal sedation, tolerance, addiction, levels to cause a surge in endorphins breathing, causing breathing to stop respiratory depression and arrest, and feelings of pleasure. altogether, leading to death. unconsciousness, coma, and death. WHY DOES IT MATTER? 540% While the fast-acting nature of the effects of fentanyl may create a more powerful and immediate euphoria, these increase in fentanyl effects wear off faster, leading to the more immediate return overdose deaths of cravings and discomfort. since 2016 (CDC) With a high profit margin, Fentanyl is often mixed into heroin or is made to mimic the In talking about Fentanyl, you may hear about appearance of other opioids. Many Carfentanill, a synthetic version of Fentanyl designed individuals will not be aware that Fentanyl to be less expensive and more potent. Originally has been mixed into their heroin or other created for veterinarians to anesthetize large animals opioid, and Fentanyl is so powerful that a such as horses, it is 10,000x more potent than dose the size of grain of sand can be deadly. morphine and 1,000x more potent than Fentanyl. WHAT CAN WE DO? Increase availability and accessibility of naloxone (Narcan) Increase funding for research on effective opiod treatment and recovery Overdoses of fentanyl can be reversed Increase collaboration between public health and public safety through the immediate administration of Increase availability and accessibility of opioid treatment naloxone (Narcan). Note, Fentanyl overdoses may require higher doses to be administered Increase education and awareness of the dangers of Fentanyl due to the potency of the drug. LEARN MORE AT: recoveryaNswers.org.

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Effect of Intranasal Ketamine Vs Fentanyl on Pain
1 PROTOCOL SYNOPSIS 2 STUDY TITLE: 3 Pain Reduction with Intranasal Medications for Extremity Injuries (PRIME): A Randomized Clinical 4 Noninferiority Trial of Intranasal Ketamine vs. Fentanyl 5 6 PROTOCOL TITLE 7 Pain Reduction with Intranasal Medications for Extremity injuries (PRIME) 8 9 PRINCIPAL INVESTIGATOR: 10 Theresa M. Frey, MD 11 Assistant Professor Clinical Pediatrics 12 Division of Pediatric Emergency Medicine 13 Cincinnati Children’s Hospital Medical Center 14 513-636-7966 15 [email protected] 16 17 CO-INVESTIGATORS: 18 Matthew R. Mittiga, MD 19 Todd A. Florin, MD, MSCE 20 Michelle C. Caruso, PharmD, BCPS 21 Nanhua Zhang, PhD 22 Yin Zhang, MS 23 24 I. ABSTRACT 25 26 Introduction: Inadequate pain control in the emergency department, particularly in the pediatric 27 population, is a major health concern. The intranasal route of medication administration is gaining 28 popularity secondary to its rapid onset of action, minimal discomfort for the patient and relative 29 simplicity. When pediatric patients present with moderate to severe pain from traumatic injuries, 30 opioids are currently the most frequently used class of analgesia, but they may not always be the best 31 option for numerous reasons. Sub-dissociative dosing of ketamine has been shown to be an effective 32 alternative to opioids in providing adequate pain relief. 33 34 Objectives: The objectives of this study are to 1) determine if intranasal ketamine is non-inferior to 35 intranasal fentanyl in reduction of pain in children presenting with extremity injuries and 2) define and 36 compare the level of sedation and respiratory side effect profile associated with intranasal ketamine and 37 fentanyl.
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