Fentanyl (also known as fentanil, brand names Sublimaze,[6] Actiq, Durogesic, Duragesic, Fentora, Matrifen, Haldid, Onsolis,[7] Instanyl,[8] Abstral,[9] Lazanda[10] and others[11]) is a potent, synthetic opioid analgesic with a rapid onset and short duration of action.[12] It is a strong agonist at the μ-opioid receptors. Historically, it has been used to treat breakthrough pain and is commonly used in pre-procedures as a pain reliever as well as an anesthetic in combination with a benzodiazepine.

Fentanyl is approximately 80 to 100 times more potent than morphine and roughly 40 to 50 times more potent than pharmaceutical grade (100% pure) heroin.[13][14]

https://en.wikipedia.org/wiki/Fentanyl

Last edited Wed Oct 28, 2015, 08:21 PM - Edit history (1)

No deaths reported from pot where legal to use and can be followed.

and they are often walking and talking on very high doses. We don't use it on most patients. But, some really need it. The government has made the ordering process for our team a little harder a few years ago and those changes did make sense. I hope they don't make any more changes.

I'm a pediatric hospice nurse

100 times stronger than morphine is NOT a danger to the patient if the prescriber is well trained in prescribing the medication. Morphine is measured in mg Fentanyl is measured in mcg.

The biggest issue with Fentanyl is that it comes in patches that are like stickers and you put them on the skin and they slowly disperse over 3 DAYS. A well trained doctor often converts oral narcotics to Fentanyl and starts at a low dose then goes up and up on the patch as the pain increases. The patient usually requires breakthrough pills and the more breakthrough pills they require the higher the dose of patch they require. Cancer is a bitch so the doses pretty much always goes up because that crap is growing inside. If the patches don't work well we go to IV meds. IV morphine and dilaudid is often more effective than the patch and you can get that breakthrough medicine in the patient's system way quicker by pushing a controlled button than taking a pill.

The people with addiction issues often cut open the fentanyl patches and take a 3 day dose all at once. The lowest dose patches are 12 mcg. The highest dose patches are 100mcg. Patients are often on more than one patch.

The issues with the patch are similar issues with oxycontin. When people break oxycontin pills, a pill that is supposed to go in over 12 hours is taken all at once. Fentanyl is a 3 DAY DOSE that people are taking all at once. So damn it would be easy to overdose.

Patches are good for people like kids who hate taking pills and don't want needles. They are also good for people who have trouble keeping track of short acting vs long acting pills.

There are people who really need this medication in my opinion.

I don't know what the government should do. Educating people about the dangers definitely is important.

Geriatrics...long term care...and have the same experience with the fentanyl patches. These sickly, old, frail people can fully function on the patch, in addition to a host of other pain/psych meds on top of it. I can sleep for a week after taking two Tylenol PM's. The amount of heavy duty drugs these people can handle never ceases to amaze me.

They are very one sided. Reading the whole article doesn't give you the complexity of the issue.

It makes it harder to educate the patients who need these meds that these meds are for them and not for the addicts. I often talk to parents of dying kids who refuse narcotics for their kids in there final months weeks or even days. They say they don't want their kids to get addicted. Usually talking with them a while helps them understand that the suffering can be better controlled with the proper meds.

The resident is clearly uncomfortable & suffering, but the family only wants them to get OTC drugs. If someone's in their 80's or 90's, at the end of their life, how can the main concern be addiction?? I can understand parents with a terminally ill child being in denial or unable to accept the situation, always hoping that there's a chance their child will somehow recover. But people with elderly parents/relatives who are clearly at the end of a very long life? Why would anyone want them to needlessly suffer?

they put me out with propofol only.

in all my previous colonoscopies, they always gave me propofol, versed, and fentanyl.

it was pretty much the same. i went to sleep and don't remember anything of the procedure from the point of falling asleep.

recovery time was shorter, so seems better all around this way.

for me, anyway.

For colonoscopies in the outpatient setting, propofol is usually all that is needed for a procedure that should last on average no longer than 10 minutes. Adding in opioids and benzos only prolongs the recovery period.