Transdermal fentanil uygulaması sonucu oluşan solunum depresyonu

Transdermal fentanil, malign ve non- malign olgularda kronik ağrının tedavisinde kullanılan etkili ve iyi tolere edilebilir bir opioid uygulama tekniğidir. Transdermal fentanilin farmakokinetik etkisinden dolayı akut ağrının tedavisinde kullanımı uygun olamamaktadır. Biz de transdermal fentanil uygulanan bir hastada gelişen solunum depresyonu nedeniyle bu formun farmakokinetiğini ve yan etkilerini gözden geçirmek istedik.

Respiratory depression due to transdermal fentanyl

Transdermal fentanyl patch is an effective and well tolerated opioid technique in malignant and non-malignant cases. Because of the pharmacokinetic effect of transdermal fentanyl, it is not advised to be used in acute pain syndrome. In this paper, we revised the literature about adverse effects and discussed the risk of the respiratory depression in a patient who received transdermal fentanyl patch.

___

  • 1. Kornick CA, Santiago PJ, Moryl N, Payne R, Obbens EA. Benefit-risk assessment of transdermal fentanyl for the treatment of chronic pain. Drug Saf 2003; 26(13): 951-73.
  • 2. Peng PW, Sandler AN. A review of the use of fentanyl analgesia in the management of acute pain in adults. Anesthesiology 1999; 90: 576–599.
  • 3. Roy. SD, Flynn GL. Transdermal delivery of narcotic analgesics: comparative permeabilities of narcotic analgesics through human cadaver skin. Pharm Res 1989; 6: 825–832.
  • 4. Gourlay GK, Kowalski SR, Plummer JL, et al. The transdermal administration of fentanyl in the treatment of postoperative pain: pharmacokinetics and pharmacodynamic effects. Pain 1989; 37: 193–202.
  • 5. Grond S, Radbruch L, Lehmann KA. Clinical pharmacokinetics of transdermal opioids: focus on transdermal fentanyl. Clin Pharmacokinet 2000; 38 :59–89.
  • 6. Edinboro LE, Poklis A, Trautman D, et al. Fatal fentanyl intoxication following excessive transdermal application. J Forensic Sci 1997; 42: 741–743.
  • 7. Arvanitis ML, Satonik RC. Transdermal fentanyl abuse and misuse. Am J Emerg Med 2002; 20: 58–59.
  • 8. Marquardt KA, Tharratt RS. Inhalation abuse of fentanyl patch. J Toxicol Clin Toxicol 1994;32:75–78.
  • 9. Desio JM, Bacon DR, Peer G, Lema MJ. Intravenous abuse of transdermal fentanyl therapy in a chronic pain patient. Anesthesiology 1993; 79:1139–1141.
  • 10. Grond S, Radbruch L, Lehmann KA. Clinical pharmacokinetics of transdermal opioids: focus on transdermal fentanyl. Clin Pharmacokinet 2000; 38: 59–89.
  • 11.Varvel JR, Shafer SL, Hwang SS, Coen PA, Stanski DR. Absorption characteristics of transdermally administered fentanyl. Anesthesiology 1989; 70: 928–934.
  • 12. Inturrisi CE. Clinical pharmacology of opioids for pain. Clin J Pain 2002; 18: 3–13.
Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal