Drug General Information (ID: DDI0BFRUML)
Drug Name			Alfentanil		Drug Info		Fospropofol		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anesthetics				Anesthetics
Structure

Mechanism of Alfentanil-Fospropofol Interaction (Severity Level: Moderate)
Additive cardiorespiratory depression effects Click to Show/Hide Mechanism Graph
Drug Name		Alfentanil				Fospropofol
Mechanism 1		Cardiorespiratory depression effects				Cardiorespiratory depression effects
Key Mechanism Factor 1
		Factor Name		Cardiorespiratory depression effects
		Factor Description		Cardiorespiratory depression is a reduction or inhibition of the normal function of the heart and lungs. The heart and lungs are the most important organs of the body's circulatory system, and when excessively depressed may result in decreased heart rate, decreased blood pressure, heart failure, slowed breathing (little to no visible chest movement), apnea, narrowed or pinpoint pupils, and seizures.
Mechanism Description		Additive cardiorespiratory depression effects by the combination of Alfentanil and Fospropofol
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Alfentanil				Fospropofol
Mechanism 2		CNS depression effects				CNS depression effects
Key Mechanism Factor 2
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Alfentanil and Fospropofol

Recommended Action
Management		To prevent intraoperative overdose and prolongation of recovery, the dosage of alfentanil given for suppression of surgical stimuli should be reduced when fospropofol or propofol is coadministered. Patients should be monitored closely for excessive sedation and cardiorespiratory depression, and the medication dosage(s) adjusted accordingly. Supportive therapy should be provided if needed.

References
1	Gill SS, Wright EM, Reilly CS "Pharmacokinetic interaction of propofol and fentanyl: single bolus injection study." Br J Anaesth 65 (1990): 760-5. [PMID: 2265045]
2	IselinChaves IA, Flaishon R, Sebel PS, Howell S, Gan TJ, Sigl J, Ginsberg B, Glass PSA "The effect of the interaction of propofol and alfentanil on recall, loss of consciousness, and the bispectral index." Anesth Analg 87 (1998): 949-55. [PMID: 9768800]
3	Product Information. Diprivan (propofol). Zeneca Pharmaceuticals, Wilmington, DE.
4	Product Information. Lusedra (fospropofol). Eisai Inc, Teaneck, NJ.
5	Stanski DR, Shafer SL "Quantifying anesthetic drug interaction. Implications for drug dosing." Anesthesiology 83 (1995): 1-5. [PMID: 7604988]
6	Vuyk J, Lim T, Engbers FH, Burm AG, Vletter AA, Bovill JG "The pharmacodynamic interaction of propofol and alfentanil during lower abdominal surgery in women." Anesthesiology 83 (1995): 8-22. [PMID: 7605022]