Fentanyl placement? - page 2

Ive always understood that Fentanyl patches can be placed anywhere,chest back etc. But we have one nurse,who recently went to a Pain Seminar,that insists the patch must be place ot the torso,as it is absorbed best there. She... Read More

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    TELL ME somebody didn't do this.................



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    Dave, you'd be surprised.

    Adrienne, who shakes her head on a daily basis.
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    Originally posted by MD Terminator
    TELL ME somebody didn't do this.................


    Every now and then I hear this from patients...they tell me their doctor or pharmacist told them it was okay to cut their 25 mcg duragesic patch in half, tape the open side shut and apply.

    Originally posted by MD Terminator
    I've seen them given to little old ladies who's bones were merely covered by skin that was literally dripping off of them... and people were wondering why they were crying in pain.
    Duragesic forms a packet of the drug in the fat layer and absorbs through that. No fat... no go.
    Wish I had a dollar for every cachexic patient in pain that I've found a duragesic patch on.
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    I guess the fentanyl half-dosing thing has happened often enough for somebody to do a study on why it shouldn't be done.
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    Check out http://www.duragesic.com/ for answers
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    We find that duragesic patches will stick longer and better if you place a piece of tegaderm over it to help reinforce the secureness to the skin, and sometimes a swipe of skin prep along the outer edge will also help to keep it in place better, (Not under the patch though ,of course) The most recent pain management seminar I attended is exact with what jansgirl has stated, but we were told not to place them over the boney prominances as the medication needs the fatty layer to absorb.( a problem with ineffective management of pian in a very skinny boney person)

    Thanks for letting me share!
    1962mom likes this.
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    Anybody ever thought of using Dermabond?

    Just something that crossed my mind today, and thought I would share.

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    if my pt. is bony, frail, etc., i never use the chest wall but do prefer the tricep area or upper back covered by an opsite. for the pd nurses that don't use the opsite, one of the biggest interferences is when the cnas sprinkle talcum powder on them, or lotion them up-both of which will affect the sticking power. i've had great success with duragesic in my elderly, cancer/cachetic pts., again, as long as it's covering an adequate area of sc fat.
    1962mom likes this.
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    I have to agree with your nurse that gets bent out of shape. One of the reasons it is best absorbed is because on the chest (best placed) is because of the type of fatty tissue their and the ability for it to be absorbed equally and timely.
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    Just a note, on women...

    I don't suggest placing these patches in a place where that the drug would absorb through breast tissue.

    Just a little something that I advise. No clinical data, no studies. I just don't like the idea of any drug passing through there when we don't need it to. We certainly don't place HRT/ERT patches there.

    redhotzz likes this.

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