These cases even go to the point of diverters removing used patches from dementia patients. Looking for more real world clinical pearls? Check out the 30 medication mistakes I see in my everyday practice as a clinical pharmacist — a free resource for subscribers.
I totally agree with your post and the dangers of fentanyl. I would like to add one more concern. If a patient has a fever, uses an electric blanket or sits in a warm bath, the drug will be released from the patch much quicker and the patient may be at risk of toxicity.
Patients need to be well educated on the patch before they use it. Actually the bath or shower need to be really long before it does a difference thats noticable …. I would add two other problems. In a very hot climate when sweating is problem, I found the patches did not adhere well. I saw some patients when the duration of the patch was about 48 hours. They were coming back sooner and in a lot of pain. This is not necessarily the correct interpretation across the board and each patient should be monitored individually for actual response vs time curve.
My most recent time under the knife, of one of the most outstanding Neurosurgeons in my area, performed a revision and fusion of C5-C6-C7 with hardware , then in 3 weeks a laminectomy at my Pro-Disc level, L3-L4. The laminectomy failed to produce relief and resulted in another entry at that level to stabilize the joint 10 days after the initial procedure.
I changed to the smaller coverderm patch as I titrated down to 50 mcg fentanyl with the same, excellent results. Wash your hands with soap and water to remove any potential residue on your fingers. NEVER apply any form of alcohol gel hand wash as that will just push the drug into your skin tissue.
With the new I really like having more options. We advise our patients to fold in half and take to the drug disposal site. People keep medications from animals and children all the time.
Kind of seems like telling someone to flush their insulin syringe in the trash versus properly storing in container for disposal. Learn how to apply and remove a transdermal patch. Transdermal patch application is easy, but as the nurse you must know how to properly remove and apply a patch. This tutorial will cover the application of a Fentanyl transdermal patch. What are transdermal patches? They are medicated sticky, adhesive patches wore on the skin. The adhesive backing on the patch that sticks to the skin contains medication that is continuously delivered via the skin to the bloodstream.
Many different types of medications can be ordered via the transdermal route. One of these medications are Fentanyl. What is Fentanyl? It is an opioid pain medication used to treat severe pain. It is very important that you understand the rules of the Opioid Analgesic REMS program to prevent addiction, abuse, and misuse of fentanyl.
This medicine should also come with a Medication Guide and patient instructions. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information.
Ask your doctor if you have any questions. A nurse or other trained health professional will give you this medicine after surgery. You will be taught how to use this medicine in the hospital, but the patch will be removed by your healthcare provider before you leave the hospital. Do not leave the hospital with the patch on your skin.
A certain amount of the medicine must build up in the skin before it is absorbed into the body. Up to a full day 24 hours may pass before the first dose begins to work. Your doctor may need to adjust the dose during the first few weeks before finding the amount that works best for you.
Even if you feel that the medicine is not working, do not increase the amount of fentanyl skin patch that you apply. Instead, check first with your doctor.
You will probably need to take a faster-acting narcotic by mouth to relieve pain during the first few days of using fentanyl skin patch. You may also need another narcotic while your dose of fentanyl is being adjusted, and to relieve any "breakthrough" pain that occurs later on.
Be sure you do not take more of the other narcotic, and do not take it more often than directed. Taking 2 narcotics together can increase the chance of serious side effects. Grapefruit and grapefruit juice may increase the effects of fentanyl skin patch by increasing the amount of the medicine in your body. You should not consume grapefruit products while you are using this medicine. The dose of this medicine will be different for different patients.
Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
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