Narcotic fentanyl

As with any narcotic, fentanyl is addictive. Because it interacts with the mu receptor, which has an effect on addiction, it is highly addictive. Fentanyl users also build a tolerance to the drug s effects, thus needing more of the drug to reach the same euphoric experiences. Building up a tolerance to the drug can be harmful to the user. As the user continues to consume more and more of the drug to achieve the same effects, an overdose becomes likely. 

An exception to the relatively safe use of high-potency agents has been noted in the combination of droperidol with the narcotic fentanyl, which can cause marked hypotension (27). 

The narcotic, fentanyl, which is widely used as an anesthetic, has become abusecL In Philadelpbia, there were 53 fatal doses between April and June 2006. In Chicago, there were 100 deaths in 2006. Across the entire United States, there were at least 500 deaths in 2006. Fentanyl is often mixed with heroin to boost tbe high, and it is sold under the street names of Drop Dead, Lethal Injection, and Get High or Die Trying. In Baltimore, the heroin-addicted population is estimated to be 60,000. Fentanyl is sold on the street under the names China White and Tango Cash. 

In preparation for chemoembolization, all patients fast overnight and are hydrated with intravenous fluids prior to the procedure. Prophylactic antibiotics, corticosteroids (Decadron), and antiemetics (Odanse-tron, Zofran, etc.) are variably given at the outset of the procedure depending on institutional protocols. At MDACC, antibiotics are not administered routinely prior to the procedure but Decadron and Zofran are given. Sedation is typically accomplished by intravenous narcotics (fentanyl and dilaudid), in addition to midazolam HCl (Versed) or other benzodiazepines. For patients with carcinoid or pancreatic neuroendocrine metastasis to the hver, 200 pg of octreotide are given just prior to the procedure and additional doses of octreotide 200 pg, are administered as needed to control the side effects of carcinoid syndrome (carcinoid crisis - hypertension, flushing, etc.). 

Several additional piperidines were active analgesics. Bie 3-methyl derivative of the potent narcotic fentanyl was 10 times more potent than the parent drug.3i N-[2-(2-Cbcazolidinone-5-yl)ethyl]-4-phenyl-l -propion-oxypiperidine showed morjAilne-llke analgesic TOtency,32 jmcl an N-(2-indanyl )-analog had meperidine-like potency.33... 

Fentanyl transdermal is a transdermal system that is effective in the management of the severe pain associated with cancer. The transdermal system allows for a timed-release patch containing the drug fentanyl to be activated over a 72-hour period. A small number of patients may require systems applied every 48 hours. The nurse monitors for adverse effects in the same manner as for other narcotic analgesics (eg, the nurse notifies the primary health care provider if the respiratory rate is 10/min or less). 

This type of pain management is used for postoperative pain, labor pain, and cancer pain. The most serious adverse reaction associated with the administration of narcotics by the epidural route is respiratory depression. The patient may also experience sedation, confusion, nausea, pruritus, or urinary retention. Fentanyl is increasingly used as an alternative to morphine sulfate because patients experience fewer adverse reactions. 

Epidural analgesia is frequently used for lower extremity procedures and pain (e.g., knee surgery, labor pain, and some abdominal procedures). Intermittent bolus or continuous infusion of preservative-free opioids (morphine, hydromorphone, or fentanyl) and local anesthetics (bupivacaine) may be used for epidural analgesia. Opiates given by this route may cause pruritus that is relieved by naloxone. Adverse effects including respiratory depression, hypotension, and urinary retention may occur. When epidural routes are used in narcotic-dependent patients, systemic analgesics must also be used to prevent withdrawal since the opioid is not absorbed and remains in the epidural space. Doses of opioids used in epidural analgesia are 10 times less than intravenous doses, and intrathecal doses are 10 times less than epidural doses (i.e., 10 mg of IV morphine is equivalent to 1 mg epidural morphine and 0.1 mg of intrathecally administered morphine).45... 

Few studies have explored the efficacy of opioids specifically for OA. The APS recommends against the use of codeine and propoxyphene for OA because of the high incidence of adverse effects and limited analgesic effectiveness. Oxycodone is the most extensively studied of the agents recommended for OA. However, other narcotic analgesics such as morphine, hydromorphone, methadone, and transdermal fentanyl are also effective. 

The IV or IM administration of parenteral narcotics (meperidine, morphine, fentanyl) is commonly used to treat the pain associated with labor. Compared to epidural analgesia, parenteral opioids are associated with lower rates of oxytocin augmentation, shorter stages of labor, and fewer instrumental deliveries. 

Concomitant narcotic administration - The respiratory depressant effect of fentanyl may persist longer than the analgesic effect. Consider the total dose of all opioid analgesics used before ordering narcotic analgesics during recovery from anesthesia. Use opioids in reduced doses initially, %to 1/3 those usually recommended. 

Opioids/narcotics (codeine, fentanyl, hydrocodone, hydromorphone, meperidine [Demerol], morphine, oxycodone [OxyContin], propoxyphene [Darvon]) (see also individual agents in index) Street Names ... 

Fentanyl, a potent synthetic narcotic analgesic, and norfentanyl were determined in postmortem samples nsing liqnid-liquid extraction (LLE) and HPLC-ESI(h-)-MS-MS enabling the authors to determine the distribntion of parent compound and metabolite in tissnes and organs of a suicidal fatality case [36]. However, matrix effects were not investigated. 

Fentanyl is a semi-synthetic opioid, ft is a much more powerful version of morphine. Fentanyl is used during surgery as an anesthetic and is extremely dangerous when taken in a nonmedical context. First created in Belgium in the 1950s, fentanyl is 80 times more powerful than morphine. Due to its strength, fentanyl is listed as a Schedule I narcotic in the United States. 

Naloxone Narcotic drugs, other opioid derivatives A specific antagonist of opioids 1-2 mg initially by IV, IM, or subcutaneous injection. Larger doses may be needed to reverse the effects of overdose with propoxyphene, codeine, or fentanyl derivatives. Duration of action (2-3 hours) may be significantly shorter than that of the opioid being antagonized. 

A man died after his wife mistakenly applied six transdermal patches to his skin at one time. The multiple patches delivered an overdose of the narcotic pain medicine fentanyl through his skin. 

An important step for the treatment of severe pain was made in the early 1960s Paul Janssen s exploitation of 4-piperidone chemistry proved remarkably successful in that it led to the clinical use of both a major tranquilizer (haloperidol) and a potent narcotic analgesic, fentanyl. Fentanyl is related to pethidine and also to basic anilides with analgesic properties and is characterized by high potency and short duration of action. Again, a series of derivatives was synthesized over the following decades which led to several products for clinical use, however fentanyl is still very important for the treatment of severe pain. 

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