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a salt or ester of citric acid
cause to form a salt or ester of citric acid

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クエン酸塩

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/24 16:16:10」(JST)

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Sufentanil (R30730, brand name Sufenta) is a synthetic opioid analgesic drug approximately 5 to 10 times more potent than its parent drug, fentanyl, and 500 times as potent as morphine. Sufentanil is marketed for use by specialist centers under different trade names, such as Sufenta and Sufentil (India, by Claris Lifesciences Ltd.). Sufentanil was synthesized at Janssen Pharmaceutica in 1974.^[1]

Sufentanil with and without lidocaine or mepivacaine is available as a transdermal patch similar to Duragesic in Europe under trade names such as Chronogesic.

Uses

The main use of this medication is in operating suites and critical care where pain relief is required for a short period of time. It also offers properties of sedation and this makes it a good analgesic component of anesthetic regimen during an operation.^[2] It is usually administered under the doctor's order through an intravenous route. In some countries, sufentanil is only indicated for epidural use. Despite this, it is often used off-label both intravenously and intranasally. A transdermal sufentanil patch called Transdur-sufentanil is about to enter^[when?] Stage III clinical trials by Durect Corp for the relief of chronic pain, and has the advantage over fentanyl patches such as Duragesic of only needing to be applied once per week. Sufentanil is also used off-label in intrathecal pumps.

Because of its extremely high potency, it is often used in surgery and post-operative pain management for patients that are heavily opioid dependent/opioid tolerant because of long term opiate use for chronic pain or illicit opiate use. Currently Sufentanil is the strongest opioid painkiller available for use in humans. Although stronger narcotic pain medications do exist, all medications stronger than Sufentanil are approved for veterinary use only. It is also used in surgery and post operative pain control in patients that are taking high dose Buprenorphine for chronic pain because it is the only opioid that has a potency and binding affinity strong enough to displace Buprenorphine from the opioid receptors in the central nervous system and provide analgesia.^[3]^[4]

Overdose Management

Because Sufentanil is very potent, practitioners must be prepared to reverse the effects of the drug should the patient exhibit symptoms of overdose such as respiratory depression or respiratory arrest. Like all other opioid-based medications, Naloxone (trade name Narcan) is the definitive antidote for overdose. Depending on the amount administered, it can reverse the respiratory depression and, if enough is administered, completely reverse the effects of Sufentanil. In these situations, doctors will normally only administer enough Naloxone to reverse the respiratory depression to the point where the patient begins breathing on their own again. Completely reversing the effects of the Sufentanil would result in the patient being suddenly forced into opiate withdrawal and all of the negative side effects that come with it.^[5]^[6]

Side effects

It is essential for the administering medical professional to be trained in airway management with readily available airway equipment because the drug causes significant respiratory depression and may cause respiratory arrest if given too rapidly or in too high a dose. Other opioid side effects such as heart rhythm irregularity, blood pressure changes and nausea/vomiting can also be present in patients given this drug and should be dealt with accordingly.

Sufentanil has been associated with extremely rare instances of life-threatening anaphylaxis.^{[medical citation needed]}

References

^ Niemegeers CJ, Schellekens KH, Van Bever WF, Janssen PA (1976). "Sufentanil, a very potent and extremely safe intravenous morphine-like compound in mice, rats and dogs". Arzneimittel-Forschung 26 (8): 1551–6. PMID 12772.
^ Savoia G, Loreto M, Gravino E (September 2001). "Sufentanil: an overview of its use for acute pain management". Minerva Anestesiologica 67 (9 Suppl 1): 206–216. PMID 11778119.
^ http://www.pdr.net/drug-summary/fentanyl-citrate?druglabelid=2474
^ Buprenorphine
^ http://www.rxlist.com/sufenta-drug/overdosage-contraindications.htm
^ http://evzio.com/hcp/?gclid=CNC0mca_3sQCFQuMaQodggwAhQ

UpToDate Contents

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1. 術後疼痛のマネージメント management of postoperative pain
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3. 危篤状態の成人患者における疼痛管理 pain control in the critically ill adult patient
4. 非心臓手術施行時の肥満患者に対する麻酔 anesthesia for the obese patient undergoing non cardiac surgery
5. 重症患者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 patients properties dosage regimens and adverse effects

English Journal

The toxic effect of opioid analgesics on human sperm motility in vitro.

Xu B, Wang ZP, Wang YJ, Lu PH, Wang LJ, Wang XH.SourceDepartment of Anesthesiology, Affiliated Wuxi People's Hospital of Nanjing Medical University , Wuxi , China.
Drug and chemical toxicology.Drug Chem Toxicol.2013 Apr;39(2):205-8. doi: 10.3109/01480545.2012.710621. Epub 2012 Aug 30.
Opioid analgesics are the most common therapeutic analgesic for acute pain. In this study, the toxicological and pharmacological features of a group of opioid analgesics were characterized by the motility of human sperm. Aliquots of sperm were incubated with various concentrations of opioid analgesi
PMID 22931048

[A national survey on pain management before tracheal intubation in neonates in French type III maternity units.]

Bissuel M, Deguines C, Tourneux P.SourceService de médecine néonatale et réanimation pédiatrique polyvalente, CHU d'Amiens, 80054 Amiens cedex 1, France.
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie.Arch Pediatr.2012 Dec 13. pii: S0929-693X(12)00495-2. doi: 10.1016/j.arcped.2012.11.004. [Epub ahead of print]
BACKGROUND: Various analgesics and sedatives are currently available for critically ill newborns requiring tracheal intubation in the delivery room. Even if pain management has improved over the past few years, there are few recent data on the French clinical practices in the delivery room.OBJECTIVE
PMID 23245868

「スフェンタニル」

Sufentanil
Systematic (IUPAC) name
	N-[4-(methoxymethyl)-1-(2-thiofuran-2-ylethyl)-4-piperidyl]-N-phenylpropanamide
Clinical data
Trade names	Sufenta
AHFS/Drugs.com	monograph
Pregnancy; category	US: C (Risk not ruled out);
Legal status	AU: Controlled (S8); UK: Class A; US: Schedule II; ℞ (Prescription only);
Routes of; administration	IV, IM, SubQ, epidural, intrathecal, transdermal patch (in clinical trials)
Pharmacokinetic data
Biological half-life	162 minutes
Identifiers
CAS Registry Number	56030-54-7
ATC code	N01AH03
PubChem	CID: 41693
IUPHAR/BPS	3534
DrugBank	DB00708
ChemSpider	38043
UNII	AFE2YW0IIZ
KEGG	D05938
ChEBI	CHEBI:9316
ChEMBL	CHEMBL658
Chemical data
Formula	C22H30N2O2S
Molecular mass	386.552 g/mol
	SMILES O=C(N(c1ccccc1)C2(COC)CCN(CC2)CCc3sccc3)CC ;
	InChI InChI=1S/C22H30N2O2S/c1-3-21(25)24(19-8-5-4-6-9-19)22(18-26-2)12-15-23(16-13-22)14-11-20-10-7-17-27-20/h4-10,17H,3,11-16,18H2,1-2H3 ; Key:GGCSSNBKKAUURC-UHFFFAOYSA-N ;
Physical data
Melting point	97 °C (207 °F)
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　　[★]

英: sufentanil
化: クエン酸スフェンタニル sufentanil citrate
商: Sufenta

合成麻薬性鎮痛薬;神経遮断麻酔薬

「クエン酸スフェンタニル」

　　[★]

英: sufentanil citrate
関: スフェンタニル

[pmid12772-1] Niemegeers CJ, Schellekens KH, Van Bever WF, Janssen PA (1976). "Sufentanil, a very potent and extremely safe intravenous morphine-like compound in mice, rats and dogs". Arzneimittel-Forschung 26 (8): 1551–6. PMID 12772.

[pmid11778119-2] Savoia G, Loreto M, Gravino E (September 2001). "Sufentanil: an overview of its use for acute pain management". Minerva Anestesiologica 67 (9 Suppl 1): 206–216. PMID 11778119.

[3] ttp://www.pdr.net/drug-summary/fentanyl-citrate?druglabelid=2474

[4] Buprenorphine

[5] ttp://www.rxlist.com/sufenta-drug/overdosage-contraindications.htm

[6] ttp://evzio.com/hcp/?gclid=CNC0mca_3sQCFQuMaQodggwAhQ

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案内

sufentanil citrate