System

[FEN-tah-nil] Pregnancy Category: C

Classification: Opioid analgesic, morphine type

See also Opioid Analgesics and Fen-tanyl citrate.

Action/Kinetics: The system provides continuous delivery of fenta-nyl for up to 72 hr. The amount of fentanyl released from each system each hour depends on the surface area (25 mcg/hr is released from each 10 cm2). Each system also contains 0.1 mL of alcohol/10 cm2; the alcohol enhances the rate of drug flux through the copolymer membrane and also increases the permeability of the skin to fentanyl. Following application of the system, the skin under the system absorbs fentanyl, resulting in a depot of the drug in the upper skin layers, which is then available to the general circulation. After the system is removed, the residual drug in the skin continues to be absorbed so that serum levels fall 50% in about 17 hr. Metabolized in the liver and excreted mainly in the urine.

Uses: Restrict use for the management of severe chronic pain that cannot be managed with less powerful drugs. Only use on clients already on and tolerant to narcotic analgesics and who require continuous narcotic administration. Contraindications: Use for acute or postoperative pain (including out-patient surgeries). To manage mild or intermittent pain that can be managed by acetaminophen-opioid combinations, NSAIDs, or short-acting opioids. Hypersensitivity to fentanyl or adhesives. ICP, impaired consciousness, coma, medical conditions causing hypoventilation. Use during labor and delivery. Use of initial doses exceeding 25 mcg/hr, use in children less than 12 years of age and clients under 18 years of age who weigh less than 50 kg. Lactation.

Special Concerns: Use with caution in clients with brain tumors and bradyarrhythmias, as well as in elderly, cachectic, or debilitated individuals. Safety and efficacy have not been determined in children.

Additional Side Effects: Sustained hypoventilation.

How Supplied: Film, extended release: 25 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr

Dosage-

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