Administering Fentanyl

[johndough]

I would put this on the student section but experience nurses may have an answer for me.

So, we were asked to create a med sheet for the drugs we might encounter for our Med/Surg rotation. I was assigned "fentanyl."

While researching this, I found that it was given through many and multiple routes, but I was just wondering what is the most common route used on the Med/Surg floor?

I was leaning towards transdermal but I'm not really sure.

Thoughts?

[DBK99]

Transdermal patch. Med surg floors cannot give it IV at my hospital

[johndough]

Cool, thanks. Do you happen to know if you guys can give it orally/transmucosal? Ex. sublingual, nasal, buccal?

Thanks!

[heron, ASN, RN]

Have you checked the PDR?

[DBK99]

Personally, I've never seen it ordered or have ever given it via those routes

[Busymom2day, ADN]

I have worked on a busy surgical floor and have mostly administered it IV. It is mostly used for breakthrough surgical pain. I have also seen it used in a PCA. Now that I work on a med/tele floor where I dont give pain meds that often for acute pain i see it occasionally in a transdermal patch for chronic pain.

[BiotoBSNtoFNP]

I have never give fentanyl any other route than transdermal on my med surg/onc floor. It is usually for chronic pain, not acute pain, in my experience.

[johndough]

Thanks! I was reading into it and the transdermal is commonly used for chronic pain. I'm just a little confused on the population of the med/surg floor.

[dream'n, BSN, RN]

Most Fentanyl I've seen ordered is the transdermal patch. And in the majority of those cases it is a medication the patients came in to the hospital already prescribed for chronic pain issues. I see Fentanyl IV ordered perhaps once every year or so for a patient, in other words very, very seldom. I have never seen it ordered by any other route other than transdermal and IV.

[wanderlustnurse88, RN]

I've mostly seen it in a transdermal patch in LTC. I've also seen it used once on a medical floor IV once but we tend to use dilaudid or morphine IV.

[K+MgSO4, BSN]

IV in a PCA, subcut, transdermal

[Dranger]

In the ICU it is very common in IV infusion form as an analgesic along side a sedation med. We also use it as a push for agitation/pain control over benzos/sedatives. Very short acting but potent. Sometimes we also use it on post-op patients but Dilaudid is the usual go to drug then we go to PO forms like Hydro/Oxy.

For med surg I think transdermal patches would be the most common route.