1. This
    Last edit by Chuckie on Jan 17, '03
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    About Chuckie

    Joined: Aug '00; Posts: 96


  3. by   kewlnurse
    you're giving fentynl 3 stars? iv it's good but the patches areUSELESS!!! they dont do squat for pain and make old peope goofy
  4. by   KatWright
    Fentanyl may not be the drug of choice for some old folk, however, I take care of Oncology patients that swear by it. It gives them pain relief AND they can function. I also take care of Oncology patients that need quite a bit of breakthrough meds while on Fentanyl. I wonder how much they would need if they weren't on it.
    But remember if the patient is REALLY debilitated, and all bones, fentanyl may not be the drug for them. It needs sub Q tissue to be absorbed
    Kat, OCN
  5. by   willie2001
    They also don't work well if the patient has generalized edema. It doesn't absorb through all the excess fluid.
  6. by   P_RN
    Has anyone else used them themselves? I have.

    I must disagree with the statement that they don't work.

    They are NOT for acute pain relief.

    When I first injured my spine and was under the care of a Pain Management Physician I did use them and they provided the first days of pain control I had had in months.

    The breakthrough pain was bearable only because of the Duragesic patches.

    Patients may say they don't work, if they are expecting a "buzz" or if their pain is such that they cannot wait for the action to develop. It takes about 12 hours to begin control.
  7. by   thisnurse
    ive used it too and yes it does work. if its not working on your patient then you might see about increasing the doseage.
  8. by   kewlnurse
    I've had more patients then i can count with chronic pain from ca, and i'm here to tell ya, not a single one has stated that they have gotten good pain control from any type of duragesic, and the second you start giveing them somthing usable like oxyconting with perc for bt they are a heck of a lot better. Sorry but i would never recomend a person using a duragesic for any type of pain control
  9. by   canoehead
    One of our internists says it takes 2 days to get the full effect so people have to gradually taper down on po stuff according to their pain score, and also have breakthrough meds available.
  10. by   betts
    Fentanyl activates NMDA pain facilitatory processes, which oppose analgesia and lead to long-lasting enhancement in pain sensitivity.
  11. by   KatWright
    Each patient, each pain control plan and each cancer and its debilitating effects is different.
    The patients with chronic SBO, who cannot take PO meds, the patients with H&N Ca that cannot swallow, the patients that are confused and restless due to pain but fight when you try to give PO meds (not to mention injections)...................
    The list goes on and on.

    Yes, there are the extremely emaciated patients and the grossly edematous patients that are not candidates for this medication.
    It does take a while to get in the system, but make sure they are covered with breakthrough meds. And maybe the amount is not high enough (200 lb A&O man + 25 mcg fentanyl = failure)
    Each pain control program must be tailored for the specific patient.

    Remember, there are patients that cannot take Morphine, Dilaudid, or Percocet (oxycodone), due to allergies, so we don't give it to them.

    We must treat each patient as an individual, not as a group
  12. by   Jen911
    We use IV Fentanyl along with Versed in the ER for sedation in peds patients with good success...just have your reversal drugs in your pocket and O2 ready, especially with one doc in particular..LOL
  13. by   KatWright
    That doctor must come from a HUGE family
  14. by   nilepoc
    In my ICU, we pretty much exclusively run fentanyl IV gtt's for pain management. Some of our patients live on 100mcg's and more per hour. It works very well in sedation cases also, where we debreed a fresh burn that has not been intubated yet. Sometimes those patients will get a 250 mcg bolus, and some diprivan or ativan with it. I don't know how relavent that is to your question. as burns require huge amounts of any drug you give them, but it works for us. All patients are on monitors during administration. Airway cart at bedside.