Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review
Purpose. Fentanyl is available as a transdermal system for the treatment of chronic pain in opioid-tolerant patients; however, it carries a black box warning due to both the potency of the product and the potential for abuse. In this report, we describe a case of transbuccal and gastrointestinal in...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2011/495938 |
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| author | Andrew C. Faust Ralph Terpolilli Darrel W. Hughes |
| author_facet | Andrew C. Faust Ralph Terpolilli Darrel W. Hughes |
| author_sort | Andrew C. Faust |
| collection | DOAJ |
| description | Purpose. Fentanyl is available as a transdermal system for the treatment of chronic pain in opioid-tolerant patients; however, it carries a black box warning due to both the potency of the product and the potential for abuse. In this report, we describe a case of transbuccal and gastrointestinal ingestion of fentanyl patches and the management of such ingestion. Summary. A 32-year-old man was brought to the emergency department (ED) via emergency medical services for toxic ingestion and suicide attempt. The patient chewed and ingested two illegally purchased transdermal fentanyl patches. In the ED, the patient was obtunded, dizzy and drowsy. Initial vital signs showed the patient to be afebrile and normotensive with a heart rate of 63, respiratory rate of 16, and oxygen saturation of 100% on 2 liters nasal cannula after administration of 2 milligrams of intravenous naloxone. The patient was treated with whole bowel irrigation and continuous intravenous naloxone infusion for approximately 48 hours without complications. Conclusion. Despite numerous case reports describing oral ingestion of fentanyl patches, information on the management of such intoxication is lacking. We report successful management of such a case utilizing whole bowel irrigation along with intravenous push and continuous infusion naloxone. |
| format | Article |
| id | doaj-art-7b2a9998e01c4cefb70b788c02db5000 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-7b2a9998e01c4cefb70b788c02db50002025-02-03T05:50:16ZengWileyCase Reports in Medicine1687-96271687-96352011-01-01201110.1155/2011/495938495938Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature ReviewAndrew C. Faust0Ralph Terpolilli1Darrel W. Hughes2Department of Pharmacy Services, University Health System, 4502 Medical Drive, San Antonio, TX 78229, USADivision of Emergency Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USADepartment of Pharmacy Services, University Health System, 4502 Medical Drive, San Antonio, TX 78229, USAPurpose. Fentanyl is available as a transdermal system for the treatment of chronic pain in opioid-tolerant patients; however, it carries a black box warning due to both the potency of the product and the potential for abuse. In this report, we describe a case of transbuccal and gastrointestinal ingestion of fentanyl patches and the management of such ingestion. Summary. A 32-year-old man was brought to the emergency department (ED) via emergency medical services for toxic ingestion and suicide attempt. The patient chewed and ingested two illegally purchased transdermal fentanyl patches. In the ED, the patient was obtunded, dizzy and drowsy. Initial vital signs showed the patient to be afebrile and normotensive with a heart rate of 63, respiratory rate of 16, and oxygen saturation of 100% on 2 liters nasal cannula after administration of 2 milligrams of intravenous naloxone. The patient was treated with whole bowel irrigation and continuous intravenous naloxone infusion for approximately 48 hours without complications. Conclusion. Despite numerous case reports describing oral ingestion of fentanyl patches, information on the management of such intoxication is lacking. We report successful management of such a case utilizing whole bowel irrigation along with intravenous push and continuous infusion naloxone.http://dx.doi.org/10.1155/2011/495938 |
| spellingShingle | Andrew C. Faust Ralph Terpolilli Darrel W. Hughes Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review Case Reports in Medicine |
| title | Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review |
| title_full | Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review |
| title_fullStr | Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review |
| title_full_unstemmed | Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review |
| title_short | Management of an Oral Ingestion of Transdermal Fentanyl Patches: A Case Report and Literature Review |
| title_sort | management of an oral ingestion of transdermal fentanyl patches a case report and literature review |
| url | http://dx.doi.org/10.1155/2011/495938 |
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