Fentanyl patches

[swardboy]

I never heard of these until a Fox News report on a kid dying from opening the patch and downing all the contents....dead within minutes.

The stuff is 80 TIMES more powerful than morphine! The patch delivers it over a 3 day period. The new craze among those crazy teens today....they're so smart.

[OUDoc]

....they're so smart.
That's not the word I was thinking.

[OklahomaRed]

Fentanyl can be bad "mochas". :D

One thing that keeps us pharmacists in jobs is that everyone out there thinks this stuff is harmless because it is legal to obtain through a physician. Of course a small percent of physicians become their own best customers? :D

Clinical Teaching Back to top

Instruct patient to report use of MAO inhibitor within the last 14 days prior to initiating therapy.
Patient should avoid activities requiring mental alertness or coordination until drug effects are realized.
Warn patient to not expose extended-release patches to external heat sources while wearing the system, as this may result in potential overdose.
Patients using the device-assisted patch should be advised not to let anyone else activate the device.
This drug may cause pruritus, sweating, nausea, vomiting, xerostomia, asthenia, confusion, dizziness, sedation, urinary retention, or hypotension.
Instruct patient to report absence of pain relief or constipation.
Patient should monitor for signs/symptoms of respiratory depression and hypoventilation, especially during dose initiation or changes, or if patient is febrile.
Before application of the extended-release patch, instruct patient to wash the skin with clear water only. Do not use soap, lotion, alcohol, or oils on the skin prior to application of the extended-release patch.
Apply extended-release patch only to non-irritated skin. If necessary, hair may be clipped (not shaved) from site prior to application.
With long-term use, advise patient against sudden discontinuation of drug.
Instruct patient to avoid alcohol or other CNS depressants during drug therapy.
Advise patient there are multiple significant drug-drug interactions for this drug. Consult healthcare professional prior to new drug use (including over-the-counter and herbal drugs).

[olevetonahill]

Nevar heard of the stuff
whats its Purpose in life ?

[Tulsa_Fireman]

Instruct patient to report use of MAO inhibitor within the last 14 days prior to initiating therapy.
Patient should avoid activities requiring mental alertness or coordination until drug effects are realized.
Warn patient to not expose extended-release patches to external heat sources while wearing the system, as this may result in potential overdose.
Patients using the device-assisted patch should be advised not to let anyone else activate the device.
This drug may cause pruritus, sweating, nausea, vomiting, xerostomia, asthenia, confusion, dizziness, sedation, urinary retention, or hypotension.
Instruct patient to report absence of pain relief or constipation.
Patient should monitor for signs/symptoms of respiratory depression and hypoventilation, especially during dose initiation or changes, or if patient is febrile.
Before application of the extended-release patch, instruct patient to wash the skin with clear water only. Do not use soap, lotion, alcohol, or oils on the skin prior to application of the extended-release patch.
Apply extended-release patch only to non-irritated skin. If necessary, hair may be clipped (not shaved) from site prior to application.
With long-term use, advise patient against sudden discontinuation of drug.
Instruct patient to avoid alcohol or other CNS depressants during drug therapy.
Advise patient there are multiple significant drug-drug interactions for this drug. Consult healthcare professional prior to new drug use (including over-the-counter and herbal drugs).

Do not taunt Happy Fun Ball.

[olevetonahill]

think terminal cancer

Guess thats why I never heard of it
The last I heard folks was using the Morphine Pump.

[OklahomaRed]

Terminal cancer, long term intractible pain, etc. Heavily abused. Fentanyl is about 10X stonger than morphine, but 1/2 life is very short, thus the need to do sustained release patches. Main use is in the injectalbe form in the surgical setting by anesthesiologists when you are getting hacked in to. Prevents your blood pressure from cranking through the roof when you are getting tore into with a bone saw. :D

[Fraggle145]

Prevents your blood pressure from cranking through the roof when you are getting tore into with a bone saw. :D

I just got a mental picture there...






Sweet. :P

[Flagstaffsooner]

Hey Doc, what is the MAO inhibiter thing? Seems like everything says do not take if you are on that.

[OklahomaRed]

You don't see monoamine oxidase inhibitors used much any more. They were originally marketed as antipsychotics in the 60's and 70's. Worked real well, but have a lot of food and drug interations that can cause some serious issues. The only one still used much is Eldepryl for parkinsonism. Have to watch out taking with a bunch of drugs as well as BEER, cheese, or any other tyramine containing foods. They are trying to hit the market with a MAOI patch that will bypass all the issues with intake and the GI tract, etc.

[The]

You don't see monoamine oxidase inhibitors used much any more. They were originally marketed as antipsychotics in the 60's and 70's. Worked real well, but have a lot of food and drug interations that can cause some serious issues. The only one still used much is Eldepryl for parkinsonism. Have to watch out taking with a bunch of drugs as well as BEER, cheese, or any other tyramine containing foods. They are trying to hit the market with a MAOI patch that will bypass all the issues with intake and the GI tract, etc.

They are still usefull for taking tryptamines orally.

Fentanyl will never replace other popular opiates as a recreational drug due to the marked lack of euphoria consistent with other more popular opiates. It seems to be a drug of opportunity rather than some new teenage craze.

[r5TPsooner]

You don't see monoamine oxidase inhibitors used much any more. They were originally marketed as antipsychotics in the 60's and 70's. Worked real well, but have a lot of food and drug interations that can cause some serious issues. The only one still used much is Eldepryl for parkinsonism. Have to watch out taking with a bunch of drugs as well as BEER, cheese, or any other tyramine containing foods. They are trying to hit the market with a MAOI patch that will bypass all the issues with intake and the GI tract, etc.

No Beer? I'm out.

[OklahomaRed]

They are still usefull for taking tryptamines orally.

Fentanyl will never replace other popular opiates as a recreational drug due to the marked lack of euphoria consistent with other more popular opiates. It seems to be a drug of opportunity rather than some new teenage craze.

Dude, you know way to much about 'trippin'. :D So, you are telling me that if you take a MAOI with your "magic mushrooms" that it enhances the high? Makes it last longer? Keeps you from getting sick?

I don't know what you are talkin' about regarding marked lack of euphoria? Fentanyl (sublimaze) will hammer your dic# in the dirt. The problem is the 1/2 life is too short, and the up to high and down to not high is too short, thus if the drug seeker is after it, it might not be as sought after since it doesn't last long enough, and there is not enough time to experience the euphoria. But, it will euphoria you right to the point you quit breathing if you get enough, or haven't did opiates long enough to develop a tolerance.

It is a drug of opportunity. Heroin freaks will use anything they can get their hands on. Oxycodone, Codeine, Morphine, Meperidine (Demerol), Hydrocodone, fentanyl, whatever............ FREAKS !!! :D

Makes my job a hell of a lot harder trying to keep you out of the "stuff". :D:gary:

[PhilTLL]

Dude, you know way to much about 'trippin'. :D So, you are telling me that if you take a MAOI with your "magic mushrooms" that it enhances the high? Makes it last longer? Keeps you from getting sick?


I don't know about the other trypts, but MAO inhibition is essential for oral DMT use, as in the South American shamanic preparation Ayahuasca (http://en.wikipedia.org/wiki/Ayahuasca).


Sections of [Banisteriopsis caapi] vine are macerated and boiled alone or with leaves from any of a large number of other plants, including Psychotria viridis (chakruna in Quechua) or Diplopterys cabrerana (also known as chaliponga). The resulting brew contains MAO inhibiting harmala alkaloids and the powerful hallucinogenic alkaloid N,N-dimethyltryptamine (DMT), a psychedelic which is active orally only when combined with an MAOI.

There are very strange books available about outsiders doing shamanic experiences in Mexico and South America. Terrence McKenna was particularly profuse on the subject.

[StoopTroup]

You guys are so Sherlock Holmesy with your 7% solutions.

[Harry Beanbag]

Isn't fentanyl what they use in epidurals during childbirth?

[r5TPsooner]

One of the main problems (no offense Doc) is that doctor's has been over prescribing the Fentanyl Patch for years. In hospitals, it's simply amazing how many fly out of the Pyxis machine.

Damn, I hate when the narc count on those is off!

[OUDoc]

In my office, they aren't prescribed very often. I think they have a lot of advantages too. Drug seekers don't like them as much as oxycodone anyway.

[OKC-SLC]

Drug seekers don't like them as much as oxycodone anyway.
Check your pm's.

[The]

Dude, you know way to much about 'trippin'. :D So, you are telling me that if you take a MAOI with your "magic mushrooms" that it enhances the high? Makes it last longer? Keeps you from getting sick?

I don't know what you are talkin' about regarding marked lack of euphoria? Fentanyl (sublimaze) will hammer your dic# in the dirt. The problem is the 1/2 life is too short, and the up to high and down to not high is too short, thus if the drug seeker is after it, it might not be as sought after since it doesn't last long enough, and there is not enough time to experience the euphoria. But, it will euphoria you right to the point you quit breathing if you get enough, or haven't did opiates long enough to develop a tolerance.

It is a drug of opportunity. Heroin freaks will use anything they can get their hands on. Oxycodone, Codeine, Morphine, Meperidine (Demerol), Hydrocodone, fentanyl, whatever............ FREAKS !!! :D

Makes my job a hell of a lot harder trying to keep you out of the "stuff". :D:gary:

MAOI is not effective with pscylicibe, only with the tryptamines, like DMT (which is the active ingredient in Ayuhusca). DMT can be smoked without an MAOI, but the taste is horrible, and the effects only last ~30 minutes, where an oral dose of DMT with an MAOI can last several hours.

And yes, the fentanyl will mess you up, but it is a "dirty" high....l

[r5TPsooner]

In my office, they aren't prescribed very often. I think they have a lot of advantages too. Drug seekers don't like them as much as oxycodone anyway.

Hmmmn... My back surgeon wrote me a script for 90 of those bad boys after I had my surgery in February. I popped about 3 or 4 of them and started having heart palpitations. I called him on his mobile at 9pm on a Sunday and told him to write something else.

Vicoprofen worked better than Oxycodone did. I guess if I would have sniffed the stuff I might have gotten some relief.

[TheHumanAlphabet]

Haven't read the entire thread - so sorry.

Was a story back in January about a defect in the patches that delivered too much of a dose via the patch. My MIL was on one and we think she got a bad one and was ODed and she went downhill after that - wacked out, hallucinating, being incredibly mean, etc... After reading the story, I wonder if that is what happned to her, then it could be the 3 weeks worth of poop that had built up in her system and she hadn't gotten out of her system and was becoming toxic... Who knows. When the damn finally broke, it wasn't pretty.