437-38-7 Usage
Description
Fentanyl is a powerful synthetic opioid that is approximately 80-100 times more potent than morphine in acute pain management. It is characterized by its high lipophilicity, rapid onset, and short duration of action. Due to its high first-pass metabolism, it is not administered orally and is available in various preparations for parenteral, transdermal, and transmucosal administration.
Uses
Used in Pain Management:
Fentanyl is used as an analgesic for the management of acute and chronic pain. It is particularly effective in cases where other opioids are not sufficient or when rapid pain relief is required.
Used in Anesthesia:
Fentanyl is used as an adjunct in anesthesia to provide analgesia and sedation during surgical procedures. Its rapid onset and short duration of action make it an ideal choice for this application.
Used in Palliative Care:
Fentanyl is used in palliative care to manage severe pain in patients with terminal illnesses, such as cancer. It can be administered through transdermal patches, providing a slow and steady release of the drug over an extended period.
Used in Breakthrough Pain:
Fentanyl is used as a treatment for breakthrough pain, which is a sudden increase in pain that occurs despite ongoing pain management. New buccal/transmucosal preparations have been developed for rapid-onset breakthrough pain, aiming to provide relief within approximately 10 minutes.
Used in Drug Delivery Systems:
Fentanyl's lipophilic nature and large volume of distribution make it an ideal candidate for drug delivery systems. Various formulations, such as transdermal patches and buccal tablets, have been developed to improve its bioavailability and therapeutic outcomes.
Originator
Fentanyl,Janssen,W. Germany,1963
Manufacturing Process
To the stirred solution of 5 parts of N-(4-piperidyl)propionanilide, 6.85 parts
sodium carbonate, 0.05 part potassium iodide in 120 parts hexone is added
portionwise a solution of 3.8 parts β-phenylethyl chloride in 24 parts 4-
methyl-2-pentanone. The mixture is stirred and refluxed for 27 hours. The
reaction mixture is filtered while hot, and the filtrate is evaporated. The oily
residue is dissolved in 160 parts diisopropyl ether and the solution is filtered
several times until clear, then concentrated to a volume of about 70 parts. The
residue is then cooled for about 2 hours at temperatures near 0°C to yield N-
[1-(β-phenylethyl)-4-piperidyl]propionanilide, melting at about 83° to 84°C as
described in US Patent 3,141,823.The starting material is prepared by reacting 1-benzyl-4-piperidone with
aniline, reducing the condensation product with lithium aluminum hydride,
reacting the product thus obtained with propionic anhydride, then hydrogen.
Therapeutic Function
Narcotic analgesic
Hazard
Toxic.
Clinical Use
Fentanyl (Sublimaze) and its related phenylpiperidine
derivatives are extremely potent drugs.They are used as
adjuncts to anesthesia, and fentanyl may be given transdermally
as an analgesic and as an oral lozenge for the
induction of anesthesia, especially in children who may
become anxious if given IV anesthesia.
Fentanyl is 80 to 100 times as potent as morphine.
Sufentanil (Sufenta) is 500- to 1,000-fold more potent
than morphine, while alfentanil (Alfenta) is approximately
20 times more potent than morphine. Their onset
of action is usually less than 20 minutes after administration.
Dosage is determined by the lean body mass
of the patient, since the drugs are lipophilic and tend to
get trapped in body fat, which acts as a reservoir, prolonging
their half-life. In addition, redistribution of the
drugs from the brain to fat stores leads to a rapid offset
of action. Droperidol, a neuroleptic agent, is generally
administered in combination with fentanyl for IV anesthesia.
Fentanyl transdermal patches are available for analgesia
in chronic pain and for postsurgical patients. The
use of the patch is contraindicated, however, for patients
immediately after surgery because of the profound
respiratory depression associated with its use.
The patches must be removed and replaced every 3
days. The onset of action of transdermal fentanyl is
slower than that of oral morphine. Thus, patients may
require the use of oral analgesics until therapeutic levels
of fentanyl are achieved. Fentanyl lozenges have
been used to induce anesthesia in children and to reduce
pain associated with diagnostic tests or cancer in
adult patients. However, all of the adverse side effects
associated with morphine are produced with far greater
intensity, but shorter duration, by fentanyl in the patch,
the lozenge, or IV administration. Given the abuse liability
of fentanyl, controversy exists as to the ethics of
marketing a lollipop lozenge form.
Sufentanil is much more potent than fentanyl and is
indicated specifically for long neurosurgical procedures.
In such patients, sufentanil maintains anesthesia over a
long period when myocardial and cerebral oxygen balance
are critical.
Side effects
In addition to all of the adverse effects and contraindications
previously described for morphine, the following
contraindications apply specifically to these drugs.
They are contraindicated in pregnant women because
of their potential teratogenic effects. They also can
cause respiratory depression in the mother, which reduces
oxygenation of fetal blood, and in the newborn;
the incidence of sudden infant death syndrome (SIDS)
in the newborn is also increased.
Cardiac patients need to be monitored closely when
receiving these drugs because of their bradycardiac effects
(which can lead to ectopic arrhythmias), and hypotensive
effects resulting from prolonged vasodilation.
In addition, the drugs stiffen the chest wall musculature,
an effect reversed by naloxone.
Safety Profile
Poison by intraperitoneal routes. Human systemic effects by intravenous route: somnolence, respiratory depression. When heated to decomposition it emits toxic fumes of NOx.
Drug interactions
Potentially hazardous interactions with other drugs
Antibacterials: metabolism increased by rifampicin.
Antidepressants: possible CNS excitation or
depression (hypertension or hypotension) in patients
also receiving MAOIs (including moclobemide) -
avoid concomitant use; possibly increased sedative
effects with tricyclics.
Antifungals: concentration increased by triazoles.
Antihistamines: increased sedative effects with
sedating antihistamines.
Antipsychotics: enhanced hypotensive and sedative
effects.
Antivirals: concentration increased by ritonavir;
increased risk of ventricular arrhythmias with
saquinavir - avoid.
Cytotoxics: use crizotinib with caution.
Dopaminergics: avoid with selegiline.
Sodium oxybate: enhanced effect of sodium oxybate
- avoid concomitant use
Metabolism
Fentanyl is metabolised in the liver by N-dealkylation
and hydroxylation via the cytochrome P450 isoenzyme
CYP3A4. Metabolites and some unchanged drug are
excreted mainly in the urine. The short duration of action
is probably due to rapid redistribution into the tissues
rather than metabolism and excretion. The relatively
longer elimination half-life reflects slower release
from tissue depots.The main metabolites of fentanyl, which are excreted in the urine, have been identified
as 4-N-(N-propionylanilino) piperidine and 4-N-(Nhydroxypropionylanilino) piperidine; 1-(2-phenethyl)-
4-N-(N-hydroxypropionylanilino) piperidine is a minor
metabolite. Fentanyl has no active or toxic metabolites.
Check Digit Verification of cas no
The CAS Registry Mumber 437-38-7 includes 6 digits separated into 3 groups by hyphens. The first part of the number,starting from the left, has 3 digits, 4,3 and 7 respectively; the second part has 2 digits, 3 and 8 respectively.
Calculate Digit Verification of CAS Registry Number 437-38:
(5*4)+(4*3)+(3*7)+(2*3)+(1*8)=67
67 % 10 = 7
So 437-38-7 is a valid CAS Registry Number.
437-38-7Relevant articles and documents
A structural study of fentanyl by DFT calculations, NMR and IR spectroscopy
Asadi, Zahra,Esrafili, Mehdi D.,Vessally, Esmail,Asnaashariisfahani, Manzarbanou,Yahyaei, Saeideh,Khani, Ali
, p. 552 - 562 (2017)
N-(1-(2-phenethyl)-4-piperidinyl-N-phenyl-propanamide (fentanyl) is synthesized and characterized by FT-IR, 1H NMR, 13C NMR, mass spectroscopy and elemental analyses. The geometry optimization is performed using the B3LYP and M06 density functionals with 6-311?+?G(d) and 6-311++G(d,p) basis sets. The complete assignments are performed on the basis of the potential energy distribution (PED) of the all vibrational modes. Almost a nice correlation is found between the calculated 13C chemical shifts and experimental data. The frontier molecular orbitals and molecular electrostatic potential of fentanyl are also obtained.
Metabolism of fentanyl and acetylfentanyl in human-induced pluripotent stem cell-derived hepatocytes
Kanamori, Tatsuyuki,Iwata, Yuko Togawa,Segawa, Hiroki,Yamamuro, Tadashi,Kuwayama, Kenji,Tsujikawa, Kenji,Inoue, Hiroyuki
, p. 106 - 114 (2018/01/11)
To evaluate the capability of human-induced pluripotent stem cell-derived hepatocytes (h-iPS-HEP) in drug metabolism, the profiles of the metabolites of fentanyl, a powerful synthetic opioid, and acetylfentanyl, an N-acetyl analog of fentanyl, in the cells were determined and analyzed. Commercially available h-iPSHEP were incubated with fentanyl or acetylfentanyl for 24 or 48 h. After enzymatic hydrolysis, the medium was deproteinized with acetonitrile, then analyzed by LC/MS. Desphenethylated metabolites and some hydroxylated metabolites, including 4′-hydroxy-fentanyl and β-hydroxy-fentanyl, were detected as metabolites of fentanyl and acetylfentanyl in the medium. The main metabolite of fentanyl with h-iPS-HEP was the desphenethylated metabolite, which was in agreement with in vivo results. These results suggest that h-iPSHEP may be useful as a tool for investigating drug metabolism.
Palladium-catalyzed hydroaminocarbonylation of alkenes with amines promoted by weak acid
Zhang, Guoying,Ji, Xiaolei,Yu, Hui,Yang, Lei,Jiao, Peng,Huang, Hanmin
supporting information, p. 383 - 386 (2016/01/12)
The weak acid has been identified as an efficient basicity-mask to overcome the basicity barrier imparted by aliphatic amines in the Pd-catalyzed hydroaminocarbonylation, which enables both aromatic and aliphatic amines to be applicable in the palladium-catalyzed hydroaminocarbonylation reaction. Notably, by using this protocol, the marketed herbicide of Propanil and drug of Fentanyl could be easily obtained in a one-pot manner.