Intranasal Fentanyl

  1. 1 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 was called to take him to the hospital for a palliative care admission. He had 4+ edema EVERYWHERE, so IV sites were very limited. The paramedic opted to give him Fentanyl intranasally and I am still amazed at how great it worked!
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    Visit  nkochrn profile page

    About nkochrn

    nkochrn has '5' year(s) of experience and specializes in 'ER, OB, Med-Surg, Geriatric'. From 'Kansas'; 31 Years Old; Joined Jun '08; Posts: 292; Likes: 252.

    15 Comments so far...

  4. Visit  leslie :-D profile page
    4
    first of all, please accept my condolences on the loss of your dad.
    time will be an invaluable ally in your healing.

    yes, i've used fentanyl intranasal a few times and it works very well.
    there are several opioids that have proven to be highly effective via the nasal passages.
    as long as there is no (nasal) obstxn or patho, then it is turning out to be a highly desirable route for meds that can't be given any other way.

    it 'sounds' like your dad passed peacefully.
    what a blessing.

    prayers for faith, comfort, and resolve.

    leslie
    nrsang97, Wise Woman RN, prnqday, and 1 other like this.
  5. Visit  tyvin profile page
    0
    Fentanyl in nasal form is not new. End of life care embraces many concepts. The nose and the anus are utilized when people can't take things in when more traditional routes fail. My condolences...
  6. Visit  JZ_RN profile page
    0
    I apologize and feel so badly for your loss. I've never had a patient with fentanyl intranasally before but it seems like a great idea.
  7. Visit  jamie876 profile page
    0
    My condolences!I just head of intranasal fentanyl...now I know!thanks
  8. Visit  blondy2061h profile page
    0
    We did nebulizer fentanyl for someone having major air hunger while dying from pneumonia, but I've never heard of intranasal fentanyl. I'm also for sorry for your loss and glad you found something to bring your father comfort at the end of life. Thanks for sharing.
  9. Visit  prnqday profile page
    0
    Sorry for your loss.
  10. Visit  samadams8 profile page
    0
    Quote from leslie :-D
    first of all, please accept my condolences on the loss of your dad.
    time will be an invaluable ally in your healing.

    yes, i've used fentanyl intranasal a few times and it works very well.
    there are several opioids that have proven to be highly effective via the nasal passages.
    as long as there is no (nasal) obstxn or patho, then it is turning out to be a highly desirable route for meds that can't be given any other way.

    it 'sounds' like your dad passed peacefully.
    what a blessing.

    prayers for faith, comfort, and resolve.

    leslie
    Yes, I've seen it work well, even for short procedures at the bedside with kids. Of course the idea of putting something in that way is not going to easy or pleasurable if the kid or person is strong enough to resist. I know that I am quite sensitive in my nasal area, and I would instinctively give a fight. But really for the kids we have given it to in the unit, well, it wasn't that bad and worked well.
  11. Visit  WildflowerRN profile page
    0
    Yes, we use fentanyl intranasally in the ED for procedures, along with versed, narcan and ativan. We use a MAD (mucosal atomization device) that screws on to the end of a syringe. Works like a charm and with similar dosing. Love it for kids and for iv drug users we can't get a line on quickly for narcan administration.
  12. Visit  Debilpn23 profile page
    0
    Quote from nkochrn
    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 was called to take him to the hospital for a palliative care admission. He had 4+ edema EVERYWHERE, so IV sites were very limited. The paramedic opted to give him Fentanyl intranasally and I am still amazed at how great it worked!
    I am so sorry for your loss. Hugs
  13. Visit  nrsang97 profile page
    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.
  14. Visit  nkochrn profile page
    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!
  15. Visit  somenurse profile page
    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.


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