Fentanyl review

Fentanyl is classified as a synthetic opioid antagonist that is used in the treatment of post-operative and chronic breakthrough pain.

Paul Janseen first developed the drug fentanyl in 1959, introduced as an intravenous anesthetic. Afterwards, fentanyl soft patches were developed as well as a flavored lollipop containing fentanyl citrate mixed with inert fillers.

Fentanyl, currently marketed as Duragesic, is used for the management of chronic pain that ranges from moderate to severe. Fentanyl becomes the option for treatment if the pain requires continuous opioid treatment for a long period of time, and NSAIDs and other painkillers cannot treat the pain.

Fentanyl is to be used only by patients already receiving opioid therapy and who have demonstrated some tolerance for opioid treatment.

Fentanyl patches are made in five different sizes: 12.5, 25, 50. 75 and 100 micrograms per hour. The dosage of the drug will be based on the patch size, and the rate of absorption depends on a number of factors such as body weight, temperature. Skin type, and the area where the patch is placed.

The major side effects of fentanyl include diarrhea, nausea, dry mouth, constipation, confusion, weakness, excessive sweating. Abdominal pain, fatigue, even anorexia, hypoventilation, hallucinations, depression, urinary retention and shortness of breath and indigestion are some less commonly reported side effects of the drug.

Fentanyl is contraindicated in patients with a known hypersensitivity to the drug, its known components and similar opioid antagonists. Fentanyl is not advised to be given to patients who are not tolerant with opioid antagonists. The drug is not used to treat acute pain, and is not used for the immediate treatment of post-operative surgical pain, mild pain. Patients with known asthma and breathing impairments are not advised to take the drug. Fentanyl is contraindicated in patients with a known history for substance abuse.

Caution must be exercised upon the usage of the transdermal patches. The use of damaged or cut patches may result in the rapid release of fentanyl and may lead to a fatal dose of the drug.

Fentanyl is not to be used as an initial drug for opioid therapy. No known studies have been made about the effects of the drug to children below 2 years of age. Fentanyl must only be administered to children if they are opioid tolerant and are 2 years old and above. Keep the patches out of reach of children. The patches must not be exposed to direct heat sources.

The use of fentanyl in non-opioid tolerant patients may lead to severe and even fatal hypoventilation, or respiratory depression. Only an experienced physician must do the administration of fentanyl, and the conversion from an opioid antagonist to fentanyl.

There are no known studies of the effects of fentanyl in the fetus of pregnant women. However, pregnant women, and women who plan to give birth, must first consult their doctor prior to the usage of the drug.

It is not known whether fentanyl is excreted into breast milk. Nursing mothers should consult their doctors before taking the drug. The potential benefits of the drug must be weighed against the risks it may pose to the nursing mother and the infant.

Fentanyl has the following structural formula:

Chemical structure of fentanyl

• Molecular formula of fentanyl is C22H28N2O
• Chemical IUPAC Name is N-(1-phenethyl-4-piperidyl)-N-phenyl-propanamide
• Molecular weight is 336.471 g/mol

Brand name(s): Actiq, Duragesic, Durogesic, Fentanest, Fentanil, Fentanila, Fentanylum, Pentanyl, Phentanyl, Sentonil, Sublimaze

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