Question about Fentanyl/Durogesic patches

Specialties Pain

Published

Fentanyl patch and relief of osteo pain

Has anyone had any experience with the use of the Durogesic/ Fentanyl patches for people who suffer from chronic osteoporosis pain?

I would appreciate any information and thoughts that any one may have on the success. I am enquiring regarding this to perhaps help the quality of life of a lady who has chronic osteo in her back and has difficulty with allergies and swallowing tablets. She has been on fosamax for 18 month or so but her quality of life recently has really deteriated due to the increased pain levels.

Thank you in advance for suggestions

Tookie

what would happen if someone would eat the contence offf 10 50mg durogesic patches? would that be leathal couse we had a patient who "tricked" us into beliving he was using them but he was only saving them for a suicide we found out later. But question is would he have made it if he would have swallowed it? Luckely a leaninglady found them in time.

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Enox,

the nature of your question is sort of alarming.

Are you a nurse, nursing student, ect?

I'm going to just say that taking any medication other than the way it is intended can cause severe harm. Duragesic's delivery system (IMHO) leaves alot to be desired, and I would discourage altering the patch in any way shape form or fashion.

Dave

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Specializes in Vents, Telemetry, Home Care, Home infusion.

even one 50mg duragesic patch can be fatal in someone who has never used narcotic pain medicines before.

this drug is interended for transdermal (skin) slow sustained release. anyone who tampers with the drug patch is at high risk of harming themselves and their loved ones.

it must be used by clients with adequate instruction and prescribed only by knowledgeable practitioners who monitor/evalute the clients pain response and side effects.

website:

http://www.duragesic.com

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Fentanyl patches are a godsend to people with chronic pain, but, all of us out there that are administering them, PLEASE be aware that there is a high risk of diversion/abuse. The literature is full of articles nowadays. I am a surveyor/inspector for my state and for CMS (the Feds) and investigated a death on a psych unit in our state related to a patient who was abusing patches (cause of death was acute fentanyl toxicity) that were legitimately prescribed by the attending on the psych unit and administered by the nursing staff. The hospital ended up in serious trouble with the Feds because the person was dead and the nursing staff could not account for the used patches.

The preferred method of disposing of them is to cut them in half and flush the two halves, according to the DEA. That way, the gel is washed out and diluted. The other acceptable method is to secure the patch(es) in a tamper-proof container until they can be incinerated. Amazingly enough, a sharps container is NOT considered a tamper-proof container by my state DEA -- they need to be LOCKED UP somewhere ...

And, as another poster mentioned, a used patch should be handled the same as any other partially used dose of narcotics -- two people should witness and sign that it was wasted.

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Specializes in LTC,Hospice/palliative care,acute care.

Isn't it SOP to check placement of the patch at least once a shift-or more frequently? It is even on our MAR-we do it and we sign it off...We have staff and residents that will pull of duragesic patches mistaking them for nitro patches...so we have to be vigilant..

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In LTC they also have a tendency to fall off during normal care activites. I've gotten calls that houskeeping found them, they came off on a showerbed, even lost one on a strecher in the ambulance.

Patches not only need to be checked Qshift, they need to be marked so that some sort of identification can be made as to whom they belong.

-Dave

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I have two...Shane and ShyAnne...they are the loves of my life. I had four miscarriages in my forties and no biological children of my own. But, I thank God for my dogs....awwwwwww yours is so cute too!

Barbara

I have also seen it used very successfully in the elderly with sever DJD (degen joint dis aka arthritis OA etc...)

One lady was so snowed from the qid (foru times a day) darvocet, she luterally was wearing a diaper b/c she had no strentgh to move. I suggested the lowest dose patch to her doc, we stopped the darvocet, and her dtr was so amazed, in a week's time, she perked up, started making it to the BR, and stopped using the doapers. Her entire quality of life was changed.

One thing, it is difficult for the elderly to manipulate this patch. I wroite to the manufacturer and c/o b/c it was so hard to see the clear backing, and I can't tell you how many times I found someone wearing the patch w the backing still on it. I asked them to color-code the doses and to make the backing and the pATCH A CONTRASTING COLOR or make an outline, so the older folks could see it. They write me back thanking me, but not sure if it has changed anything.

Also , have to dispose of the used patches carefully, it could kill a young child or animal if they ate it out of the garbage or laying around the home. They need to be folded up and flushed.

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Thank you both Renreian and kids-r-fun for replying

Forgive my ignorance - could you please give me an explanation for the followig they are not abbrevations that l am used to using

LOLs'

BID toTID dosing

Thank you both for replying

sandra

LOL's lots of laughs

BID you get medicine twice a day

TID you get medicine three times a day

I'm guessng you aren't in the health care profession and if you are your a newbie

Hope this helps

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We use the Duragesic patch for a client with severe Rheumatoid Arthritis, and it works well for pain, but it does cause her to be nauseated. Also if you have problems keeping them on, go to their web site and there is a number you can call and answer a few questions and they will send the client free biooculsive bandages to apply over the patch to keep it secure. Thought I would pass this on.

:coollook: Yesterday is the past, tomorrow is the future, and today is a gift THE PRESENT. Use it wisely.

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Where are you folks at that patients do so well with Duragesic?

I've found them virtually useless for chronic non-malignant pain.

Cancer pain does fairly well with them, especially Lung.

I write fewer Duragesic patches than any other schedule II out there.

Now the Actiq trans-mucosals... THEY'RE AWESOME!

-Dave

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Specializes in LTC,Hospice/palliative care,acute care.
Where are you folks at that patients do so well with Duragesic?

I've found them virtually useless for chronic non-malignant pain.

Cancer pain does fairly well with them, especially Lung.

I write fewer Duragesic patches than any other schedule II out there.

Now the Actiq trans-mucosals... THEY'RE AWESOME!

-Dave

In our LTC (2 out of our 3 docs are lousy at pain control issues) we have used them only for terminal cancer pain and had good results.We recently had a pain control inservice at the staff's request.It was presented by a drug rep and was a commercial for duragesic patches.She was touting it heavily for all chronic pain.She did bring us nice snackage but as for pain control she did not teach us anything we did not know and she did not make a dent with the nurses that withhold pain meds (you know---Nurse "He was asleep" Smith and Nurse" I don't want to make him stop breathing Jones" ) I have afew new residents-very challenging-multiple problems...One fella has necrotic feet and a stage 3 sacral decube...I have to give him regular tylenol round the clock before his doc will start taking him up the ladder and he will almost never write any standing orders-it's always PRN....darn shame

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Me thinks Dave needs to have an inservice with your staff!

-Dave, who wants to smack people like that.

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