Trends in transdermal fentanyl utilisation and fatal fentanyl overdose across Australia (2003–2015)

2021 ◽  
Author(s):  
Shafkat Rahman ◽  
Alex Trussell ◽  
Sallie‐Anne Pearson ◽  
Nicholas A. Buckley ◽  
Emily A. Karanges ◽  
...  
Keyword(s):  
Transdermal Fentanyl

Transdermal Fentanyl: Pharmacokinetics and Preliminary Clinical Evaluation

1989 ◽  
Vol 9 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Patricia M. Plezia ◽  
Thomas H. Kramer ◽  
Jennifer Linford ◽  
Stuart R. Hameroff
Keyword(s):  
Clinical Evaluation ◽  
Transdermal Fentanyl

Radiotherapy plus either transdermal fentanyl or paracetamol and codeine for painful bone metastases: a randomised study of pain relief and quality of life

2004 ◽  
Vol 20 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Kyriaki Pistevou-Gompaki ◽  
Vassilis E. Kouloulias ◽  
Charalambos Varveris ◽  
Kyriaki Mystakidou ◽  
Grigoris Georgakopoulos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Bone Metastases ◽  
Transdermal Fentanyl ◽  
Randomised Study ◽  
Painful Bone Metastases

Why are US military personnel prescribed transdermal fentanyl patches?

2021 ◽  
pp. bmjmilitary-2021-001894
Author(s):  
Hailey Murray ◽  
A N Gregoriou ◽  
A Lepore ◽  
G J Booth ◽  
A H Goldman ◽  
...  
Keyword(s):  
Military Personnel ◽  
Clinical Information ◽  
Opioid Therapy ◽  
Active Duty ◽  
Data Repository ◽  
Prescription Data ◽  
Transdermal Fentanyl ◽  
Military Health ◽  
Continuous Release ◽  
Us Military

IntroductionTransdermal fentanyl is a continuous release opioid delivery system intended for use in opioid-tolerant patients requiring around-the-clock opioid therapy. The purpose of this study is to identify the most common indications for transdermal fentanyl prescriptions in active duty US military personnel, and determine whether these prescriptions meet US Food and Drug Administration (FDA) labelling.MethodsActive duty US military personnel initiating transdermal fentanyl therapy with prescriptions filled at Military Health System pharmacies between 2015 and 2019 were identified in the Military Data Repository. Electronic health records were searched for patient demographic information, clinical information and prescription data. A total of 225 patients with complete data were identified.ResultsThe most common reason for transdermal fentanyl initiation was chronic non-cancer musculoskeletal pain. Among patients with non-cancer pain, 36% received their initial prescription from an internal medicine/primary care provider, and 35% did not meet published US FDA criteria for opioid tolerance prior to treatment initiation. There was an 81% decrease in patients initiating therapy between 2015 and 2019.ConclusionsWhile a substantial minority of transdermal fentanyl prescriptions to US military personnel did not meet FDA guidelines on appropriate use, the overall number of prescriptions fell dramatically over the study period. This suggests that automated profile review or additional targeted policies to limit transdermal fentanyl prescribing are unnecessary at this time.

Opioid-Induced Muscle Activity: Implications for Managing Chronic Pain

1995 ◽  
Vol 29 (11) ◽  
pp. 1118-1121 ◽  
Author(s):  
Robert K Sylvester ◽  
Ralph Levitt ◽  
Preston D Steen
Keyword(s):  
Breakthrough Pain ◽  
Oral Morphine ◽  
Opioid Therapy ◽  
Chronic Opioid Therapy ◽  
Transdermal Fentanyl ◽  
Management Options ◽  
Morphine Infusion ◽  
Involuntary Muscle ◽  
Metastatic Lung ◽  
Morphine Solution

Objective: To increase awareness of opioid-induced involuntary muscle hyperactivity and to present management options. Case Summary: A ventilator-dependent 71-year-old man presented with pain caused by metastatic lung cancer. Transdermal fentanyl therapy was titrated to 200 μg/h. Two days later a continuous morphine infusion was initiated because of frequent administration of oral morphine solution for breakthrough pain. The patient became progressively less responsive and began exhibiting involuntary muscle hyperactivity thought to represent breakthrough pain. Despite the inability to assess pain control effectively in this unresponsive patient, the morphine infusion rate was increased from 22 to 717 mg/h within 7 days. No change in muscle hyperactivity was observed. Discussion: Over the last decade involuntary muscle hyperactivity has been documented as an adverse effect of chronic opioid therapy. The literature describing the incidence of this toxicity, possible risk factors for its development, and recommendations for its management are discussed. Conclusions: The occurrence of muscle hyperactivity in an unresponsive patient receiving chronic opioid therapy may represent opioid toxicity. Recommendations for managing opioid-induced muscle hyperactivity include reduction of the opioid dosage and/or administration of clonazepam therapy.

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