同: Alfenta

WordNet

a complex consisting of an organic base in association with hydrogen chloride

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/20 23:40:51」(JST)

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Alfentanil (R-39209, trade name Alfenta, Rapifen in Australia) is a potent but short-acting synthetic opioid analgesic drug, used for anaesthesia in surgery. It is an analogue of fentanyl with around 1/4 to 1/10 the potency of fentanyl and around 1/3 of the duration of action, but with an onset of effects 4x faster than fentanyl.^[2] Alfentanil has a pKa of approximately 6.5, which leads to a very high proportion of the drug being uncharged at physiologic pH. This unique characteristic is responsible for its rapid onset. It is an agonist at mu opioid receptors.

While alfentanil tends to cause fewer cardiovascular complications than other similar drugs such as fentanyl and remifentanil, it tends to give stronger respiratory depression and so requires careful monitoring of breathing and vital signs. Almost exclusively used by anesthesia providers during portions of a case where quick, fast acting (though not long lasting) pain control is needed (i.e. during a nerve block, head pinning etc..) Alfentanil is administered by the parenteral (injected) route for fast onset of effects and precise control of dosage.

Alfentanil is a restricted drug which is classified as Schedule II in the USA, according to the U.S. DEA website.^[3]

Alfentanil was discovered at Janssen Pharmaceutica in 1976.

Side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.^[4]

References

^ Shaw, Leslie M. (2001). The clinical toxicology laboratory : contemporary practice of poisoning evaluation. Washington, DC: AACC Press. p. 89. ISBN 9781890883539.
^ Jacob Mathew, J. Kendall Killgore. Methods for the synthesis of alfentanil, sufentanil, and remifentanil. US Patent 7,208,604
^ From DEA website, accessed 23 Jan 2007
^ Jane Mounteney, Isabelle Giraudon, Gleb Denissov, Paul Griffiths (July 2015). "Fentanyls: Are we missing the signs? Highly potent and on the rise in Europe.". The international journal of drug policy. 26 (7): 626–631. doi:10.1016/j.drugpo.2015.04.003. PMID 25976511.

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UpToDate Contents

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1. 急性周術期疼痛のマネージメント management of acute perioperative pain
2. Procedural sedation in adults outside the operating room
3. 高齢患者における緊急気道マネージメント emergency airway management in the geriatric patient
4. Anesthesia for head and neck surgery
5. 危篤状態の成人における鎮静鎮痛剤：特性、投与レジメン、および副作用 sedative analgesic medications in critically ill adults properties dosage regimens and adverse effects

English Journal

Simultaneously predict pharmacokinetic interaction of rifampicin with oral versus intravenous substrates of cytochrome P450 3A/P‑glycoprotein to healthy human using a semi-physiologically based pharmacokinetic model involving both enzyme and transporter turnover.

Qian CQ, Zhao KJ, Chen Y, Liu L, Liu XD.
European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences. 2019 Jun;134()194-204.
Several reports demonstrated that rifampicin affected pharmacokinetics of victim drugs following oral more than intravenous administration. We aimed to establish a semi-physiologically based pharmacokinetic (semi-PBPK) model involving both enzyme and transporter turnover to simultaneously predict ph
PMID 31047967

Opioid-Induced Hyperalgesia in the Nonsurgical Setting: A Systematic Review.

Yang DZ, Sin B, Beckhusen J, Xia D, Khaimova R, Iliev I.
American journal of therapeutics. ;26(3)e397-e405.
Opioid-induced hyperalgesia (OIH) is a phenomenon that causes an increased pain sensitization and perception of pain to noxious stimuli secondary to opioid exposure. While this clinical effect has been described in the surgical setting, it is unclear if OIH occurs in the nonsurgical setting. To revi
PMID 29726847

Determination of Fentanyl Analog Exposure Using Dried Blood Spots with LC-MS-MS.

Seymour C, Shaner RL, Feyereisen MC, Wharton RE, Kaplan P, Hamelin EI, Johnson RC.
Journal of analytical toxicology. 2019 May;43(4)266-276.
Fentanyl, and the numerous drugs derived from it, are contributing to the opioid overdose epidemic currently underway in the USA. To identify human exposure to these growing public health threats, an LC-MS-MS method for 5 μL dried blood spots (DBS) was developed. This method was developed to detect
PMID 30462229

「アルフェンタニル」

Alfentanil
Systematic (IUPAC) name
	N-{1-[2-(4-ethyl-5-oxo-4,5-dihydro-1H-1,2,3,4-tetrazol-1-yl)ethyl]-4-(methoxymethyl)piperidin-4-yl}-N-phenylpropanamide
Clinical data
Trade names	Alfenta
AHFS/Drugs.com	Micromedex Detailed Consumer Information
MedlinePlus	a601130
Routes of; administration	Intravenous
Legal status
Legal status	AU: S8 (Controlled); CA: Schedule I; DE: Anlage III (Prescription only); UK: Class A; US: Schedule II;
Pharmacokinetic data
Bioavailability	100%
Protein binding	92%
Metabolism	Hepatic
Biological half-life	90–111 minutes
Duration of action	15 min
Identifiers
CAS Number	71195-58-9
ATC code	N01AH02 (WHO)
PubChem	CID 51263
IUPHAR/BPS	7108
DrugBank	DB00802
ChemSpider	46451
UNII	1N74HM2BS7
KEGG	D07122
ChEBI	CHEBI:2569
ChEMBL	CHEMBL634
Chemical data
Formula	C21H32N6O3
Molar mass	416.517 g/mol
	SMILES O=C1N(\N=N/N1CC)CCN3CCC(N(c2ccccc2)C(=O)CC)(CC3)COC ;
	InChI InChI=1S/C21H32N6O3/c1-4-19(28)27(18-9-7-6-8-10-18)21(17-30-3)11-13-24(14-12-21)15-16-26-20(29)25(5-2)22-23-26/h6-10H,4-5,11-17H2,1-3H3 ; Key:IDBPHNDTYPBSNI-UHFFFAOYSA-N ;
Physical data
Melting point	140.8 °C (285.4 °F)
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