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Discussion

Fentanyl Patch

We ordered a 12 mcg Fentanyl patch for our bedbound end stage Parkinsons disease and Dementia pt who was taking 3gms of Tylenol daily for generalized pain. she was moaning in pain prior to this change with also increase bp and heart rate.

Has anyone out there seen someone not come around after over a week with the Fentanyl patch? By this I mean, she has a decrease appetite, not as responsive, and generally not the same. Although no further moaning when turned. Caregiver is really upset at me, the nurse, for suggesting this change for the pt.

What have other hospice nurses seen with low dose Fentanyl patches?:eek:

Featured Replies

Recommended Initial Dose Conversion to Duragesic Patch

(Jansen-Ortho 2006) 25 ug patch = 60-134 total oral morphine

daily dose

Many Fentenyl lawsuits out there for overdosing.

Best Wishes!

I don't usually see these symptoms more than 2-3 days after starting a patch or any narcotic for that matter. It could be a sign of the decline, usually sedation is the sign of too much med but everyone has their own reaction. I would usually go from Tylenol to a prn narcotic before going to a long acting one first, then base it on how much prn the patient uses. I have had this same issue before and the care giver reacted in the same way, we try until we get it right and certainly want to control pain. Don't be haard on yourself for caring.:redpinkhe

I agree.

My first thought was that this maybe a disease process decline and not related to the patch at all.

What about gels etc or is the patient still able to swallow meds effectively without pocketing etc?

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