Intranasal Fentanyl - page 2

by nkochrn 2,970 Views | 15 Comments

Does anyone have any experience with this? Thought I'd share a personal experience. My Dad just passed away from Melanoma, he was at home on Hospice and the roxanol/ativan combo just wasn't cutting it anymore. The ambulance... Read More


  1. 0
    I am so sorry for your loss. I have never heard of intranasal fentanyl until now. I am so glad it was a help to your dad.
  2. 0
    I hadn't ever seen it until I helped with the advanced EMT class and they were taught how to do it. This was the first time I actually saw it on a real patient though. They use the MAD devices also. It seemed like the IN worked even faster than the IV, but he'd also had lots of morphine and ativan before EMS arrived to help prepare him for the transfer. A few weeks before this he'd been transferred by ambulance and had to be given 10 mg of Valium because the 400 mcg of Fentanyl he'd had in the ER wasn't enough and he was trying to crawl off the cart because it was so painful!
  3. 0
    so sorry for your loss.

    Another med i have always admired for speed of relief, is sublingual morphine, Roxanol. Only a drop or two under the tongue, and the person seemed comfortable. Of course, i've never had the med myself, but, I sure did love giving that med, felt like a magic fairy when i did. No needles, no swallowing, but Very fast relief, even for people who were suffering terribly.
  4. 2
    Quote from Jean Marie46514
    so sorry for your loss.

    Another med i have always admired for speed of relief, is sublingual morphine, Roxanol. Only a drop or two under the tongue, and the person seemed comfortable. Of course, i've never had the med myself, but, I sure did love giving that med, felt like a magic fairy when i did. No needles, no swallowing, but Very fast relief, even for people who were suffering terribly.
    sublingual is great IF the pt isn't dehydrated...
    which in many cases, they are.
    just something to consider when perusing routes of administration.

    leslie
    samadams8 and somenurse like this.
  5. 1
    Quote from leslie :-D
    sublingual is great IF the pt isn't dehydrated...
    which in many cases, they are.
    just something to consider when perusing routes of administration.

    leslie
    Leslie, if i find the sublingual area dry, i'd always moisten it, or, if patent ws able, have a sip of water first, asking them to sort of whoosh it around their mouth a bit prior to swallowing the water.
    do you think either of those interventions would help sublinqual absorption, or, have i been following wrong advice for eons?
    leslie :-D likes this.
  6. 1
    jean, i think it'd help somewhat but certainly it wouldn't reach its full potential of the med.
    same concept with fentanyl patches - they will do little when over a bony prominence or sunken chest wall.
    it needs the sq fat in order to maximize absorption.

    i wish drs would consider all this stuff when prescribing. (i detest these emoticons....want the old ones back.)

    leslie
    somenurse likes this.


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