Page 50 - Naplex Q&A 2025 Version

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The most frequently reported G.I. adverse effects administration. Fentora is formulated as a flat-
are diarrhea and abdominal pain. faced, round, beveled-edge white tablet. Fentora is
designed to be placed and retained within the
64.(a) Status epilepticus is generally defined as buccal cavity for a period sufficient to allow
severe, recurrent episodes of convulsions. disintegration of the tablet and absorption of
Fentanyl across the oral mucosa.
Valium (Diazepam) injection is indicated as an
adjunct therapy in status epilepticus. Dosage should Fentora employs the OraVescent drug delivery
be individualized for maximum beneficial effect. technology, which generates a reaction that
The usual recommended dose in older children and releases carbon dioxide when the tablet comes in
adults ranges from 2 mg to 20 mg I.M. or I.V., contact with saliva. It is believed that transient pH
depending on the indication and its severity. changes accompanying the reaction may optimize
dissolution (at a lower pH) and membrane
Parenteral Ativan (Lorazepam) has also been found permeation (at a higher pH) of Fentanyl through the
useful for the treatment of status epileptics. buccal mucosa.

65. (e) Ativan (Lorazepam) is classified as the Each tablet contains Fentanyl citrate equivalent to
benzodiazepine class of drugs. It is indicated for the Fentanyl base: 100, 200, 300, 400, 600 and 800
treatment of anxiety and insomnia. The parenteral micrograms.
form of Lorazepam reduces the severity and
duration of nausea and vomiting associated with It is indicated only for the management of
emetogenic cancer therapy. It is available in tablet, breakthrough pain in patients with cancer who are
concentrated oral solution and injection form. already receiving and who are tolerant to around-
Sedation, depression, constipation, lethargy, the-clock opioid therapy for their underlying
fatigue, diplopia and nystagmus are reported side persistent cancer pain.
effects of the drug.
Patients considered opioid tolerant are those who
Librium (Chlordiazepoxide), Tranxene (Clorazepate), are taking around-the-clock medicine consisting of
Valium (Diazepam) and Serax (Oxazepam) are at least 60 mg of oral morphine daily, at least 25
indicated for the relief of acute alcohol withdrawal mcg of transdermal Fentanyl/hour, at least 30 mg of
symptoms such as agitation, tremor, impending and oxycodone daily, at least 8 mg of oral
acute delirium. hydromorphone daily or an equianalgesic dose of
another opioid daily for a week or longer.
66. (e) Valium (Diazepam) is classified as a
benzodiazepine. It is indicated for the treatment of This product must not be used in opioid non-
anxiety, convulsion, skeletal muscle spasm and tolerant patients because life-threatening
acute alcohol withdrawal symptoms. It potentiates hypoventilation and death could occur at any dose
the effects of gamma amino butyric acid. It is in patients not on a chronic regimen of opioids. For
available in tablet, oral solution, injection and oral this reason, Fentora is contraindicated in the
Intensol solution dosage forms. management of acute or postoperative pain.

The recommended dose is 2 to 10 mg, three to four Physicians should individualize treatment using a
times a day. Sedation, depression, constipation, progressive plan of pain management. For opioid-
lethargy, fatigue, diplopia and nystagmus are tolerant patients not being converted from Actiq,
reported side effects of the drug. the initial dose of Fentora is always 100 mcg.

67.(c) Fentora (Fentanyl buccal tablet) is a potent 68.(e) One cannot switch Captopril and Zestril on
opioid analgesic, intended for buccal mucosal equivalent bases.

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