Yesterday I was writing about corneal abrasions and the medications that a physician will likely prescribe after such an injury occurs. It occurred to me today that listing some good links on "how to" administer eye drops (and other prescribed medications) to infants or toddlers would be a good idea.
Based on my past years of working as a pediatric registered nurse, I know how difficult it can be to medicate infants and toddlers. In order to give the medication with the minimum of fuss, it's best to swaddle (wrap) an infant gently but firmly in a receiving blanket so that the baby's arms are fixed at his/her side. For an older toddler, it may very well take two people to give necessary medication.
Here are two websites with rather nice information about how to give medication to infants and toddlers:
Great Ormond Street Hospital for Children: How to Give your Child Eye Drops
From the Ohio State University Medical Center: How to Give Your Baby Medicine by Mouth
Follow the Doctor's Orders
Give your child medication that is prescribed for him or her. Don't borrow or share medication meant for someone else. Store the medication as directed by your pharmacist's instructions. Most antibiotics will need to be refrigerated. Continue to give the prescribed medication for the entire period that the doctor has ordered. Don't stop the medication early because the child "seems better." Doing so can cause lingering infections that become resistant to the medication.
Do Not Give . . .
Never give aspirin to infants or children. Check the lable of any medication you intend to give. If any of the ingredients contain salycilic acids don't give your child the medication. Check the labels on all of your over-the-counter medications. Look for "black box" warning labels and other instructions to parents. Recently many cold and cough medications have been deemed dangerous to young children and the new packaging reflects such information.
Talk to your pharmacist . . .
Pharmacists do more than fill your prescriptions. They will gladly discuss over-the-counter medications with you and help you find appropriate options for your child. In addition, consult your pharmacist to determine whether or not the prescribed medication can be made more palatable for your child--by adding "better" tasting flavors by compounding the medication.
. . . .
Showing posts with label Medications. Show all posts
Showing posts with label Medications. Show all posts
Wednesday, December 16, 2009
Tuesday, December 01, 2009
DVT, Blood Clot, Deep Vein Thrombosis
Preventing a DVT is certainly much easier than curing the condition. In hospitalized patients several methods are used to enhance the flow of blood to the lower legs. First and foremost, being up and around as soon as possible, and as much as possible after surgery or while recovering from an illness is a major advantage in increasing venous flow and decreasing the chance of clots forming. Tight white compression stockings (TED hose) may be prescribed depending on the level of risk for the specific patient (see below). Mechanical "pumps" squeeze the lower legs at regular intervals in another means of prevention. For patients at the highest risk of DVT, blood thinning medication is injected daily under the skin of the abdomen.
Greater Risk of Clots for Some Patients
DVT (Deep Vein Thrombosis) can occur in almost anyone. However, certain individuals may be at increased risk for developing a DVT. Risk factors include but are not limited to:
- Recent surgical procedure (and greater chance of a DVT with a long, intense surgery and joint replacement surgeries)
- Restricted mobility from bedrest, paralysis, traveling for many hours without taking a break to walk around
- Active Cancer
- Congestive Heart Failure (CHF)--if you take "water pills" and are not sure why--ask your doctor if you have CHF
- Age greater than 40 years old
- Pregnancy and the postpartum period (6-8 weeks after delivery)
- Injury to the leg or the deep veins of the leg
- Smoking
- Use of certain medications such as birth control pills and estrogen
- Dehydration
- Polycythemia
- Obesity
- Current smoker
- Past history of having a blood clot or an inherited family tendency to develop blood clots
Check out their website to learn more about DVT and related conditions such as:
- Post Thrombotic Syndrome (PTS) After a DVT is treated and resolved, this chronic condition may result in up to 40% of all individuals. It's the result of damage done by the clot to the valves that move blood through the vein.
- Pulmonary Embolis (PE) Blood clots in the smallest vessels of the lungs.
- Thrombophila Blood that clots too easily. Hypercoagulability is another word used to describe this condition which can be inherited.
- Chronic Venous Insufficiency results when the valves in the veins that move blood don't function properly, often occurs from injury to veins caused by a DVT, from varicose veins, or as the result of an inherited condition.
The Vascular Disease Foundation has a variety of full-color brochures available for download including a great pamphlet called "Focus on Clots." (This publication was previously called "Spot a Clot," but otherwise it's the exact same informational card.)
You may also request a copy of these brochures by calling toll free: 1-888-833-4463.
- Vitamin K and Warfarin (Coumadin): http://www.nattinfo.org/documents/KandWarfarin(Web).pdf
- Family Testing for Clotting Disorders http://www.nattinfo.org/fam-test.pdf
- Sanofi-Aventis (makers of the blood thinner Lovenox) provides tips about DVT's, Risk Factors for DVTs, and includes a risk assessment tool.
A plus: Deep vein thrombosis article from eMEDtv.com
eMedTV.com has many wonderful patient education videos.
Here's a two-minute presentation that explains how unwanted blood clots occur in the vein and why they are dangerous from the: Heart Disease Health Channel on eMedTV.com
Provided by the
. . .
Tuesday, November 24, 2009
Another Black Box: Aranesp, Epogen, Procrit, What you should know about drugs that tell your body to make more red blood cells
Erythropoiesis Stimulating Agents (ESAs) tell your body to make more red blood cells. Drugs in this class include:
• Aranesp (darbopoetin alfa)
• Epogen (epoetin alfa)
• Procrit (epoetin alfa)
• There are other brand names & epoetin variants marketed worldwide
The Good News First . . .
Twenty years ago we didn’t have synthetic medications to treat anemia. Depending on the cause anemia was often treated through diet, by administering supplementary iron or vitamin B12, and frequently, by blood transfusions. The 1980's was a decade of concern over the safety of our blood supply due to blood borne pathogens such as Hepatitis B and C and the HIV virus. New technologies in recombinant DNA allowed science to explore and develop innovative alternative therapies.
In 1989, Epogen (epoetin alfa), the first of a class of drugs called erythropoiesis stimulating agents (abbreviated as “ESAs”), was approved by the FDA in the United States to treat patients suffering from anemia due to chronic kidney disease. Epogen was eventually joined by similar ESAs called Aranesp and Procrit and treatment was eventually broadened to include patients suffering from anemia related to chemotherapy.
The benefit to both groups was that they no longer needed to rely on frequent blood transfusions to treat their anemia. ESAs directly influence the body to speed up the production of its own red blood cells by introducing a synthetic version of the hormone erythropoietin. Erythropoietin is a chemical messenger of sorts with the specific mission of instructing our bone marrow to produce more red blood cells. Epogen, Aransep, and Procrit are easily given by a simple injection under the skin from one to three times per week.
So what exactly is anemia? Anemia results when we don’t have enough healthy red blood cells called erythrocytes circulating in our bloodstream. Healthy red blood cells are vital; they carry a protein called hemoglobin which picks up molecules of oxygen from our lungs and delivers it to the tissues throughout our body. We don’t store oxygen in our body but we use it continuously, and our body’s demand for oxygen is constant as oxygen molecules literally fuel every basic function that each cell in our body must perform.
Symptoms of Anemia. Moderate to severe anemia can cause symptoms of weakness, fatigue, shortness of breath, rapid/irregular heartbeat and pale skin. Milder or chronic anemia may cause subtle symptoms or no symptoms at all.
Erythropoietin. This hormone is a chemical messenger with several functions relating to the manufacture of red blood cells, preserving their lifespan in the body, and enhancing the growth of blood vessels. As we develop before birth, erythropoietin is active within our livers. After we are born, erythropoietin is manufactured and released by cells in the kidney.
Kidneys and Anemia. People often don’t think of a relationship between the kidneys and anemia, but when you carefully consider it, it makes sense for the kidney to have this function. Like a waste-water treatment plant adds chemicals based on the scientific observations of the plant technicians, the kidneys have specialized cells that detect decreased oxygen levels in the blood circulating through them, and as a result, these specialized cells release erythropoietin to enhance red blood cell formation and longevity. If the kidneys become diseased and fail, this system of checks and balances is impaired or lost. When ESAs, or synthetic erythropoietin, was first introduced in 1989, the drug was intended specifically for the benefit of patients in kidney failure.
Chemotherapy and Anemia. Cancer cells are bizarre mutant cells that divide rapidly. therefore, malignant tumors can grow large very quickly. The goal of chemotherapy is to target those rapidly-dividing bizarre cells and kill them. Other “good” rapidly-dividing cells in our body get caught in the cross-fire and are also damaged by chemo drugs. Hair is lost when rapidly-dividing cells in the roots are targeted by the chemo drugs. Other fast-growing cells affected by chemotherapy are in the digestive tract; that’s why mouth sores, nausea, and vomiting are a common consequence of chemo. The body’s rapidly dividing blood cells (red cells, white cells, and platelets) are also among the good cells that fall prey to chemotherapy. The anemia that results from chemotherapy is not caused by a lack of erythropoietin, but ESAs were approved by the FDA in 1993 to treat anemia to reduce the amount of blood transfusions necessary for patients suffering from chemotherapy-induced anemia.
Sobering News about ESAs . . .
All medications have both benefits and risks. In the U.S. the FDA places "black box warnings" on the medication labels and inserts of drugs when research suggests there is a risk of serious adverse effects. The first black box warning for ESAs appeared in March of 2007. Eight months later in November 2007, the black box warning was emphatically strengthened by the FDA.
Both the chronic renal failure and chemotherapy patients were found to have some increased risks when using ESAs. Patients with certain types of cancer were found to be at risks of tumor progression and decreased survival when taking ESAs to increase red blood cell production. Chronic renal failure patients were found to be at increased risk of developing heart attack, stroke, blood clots, heart failure and death if their ESA dose was high enough to cause them to make more than recommended number of red blood cells.
The FDA’s guidance to physicians was very specific on the recommended dosage to achieve good results without increasing patients’ risks for a bad outcome. Further, their guidance suggested that physicians specifically discuss the risks and benefits of these medications with their patients.
What’s Inside the Black Box . . . guidance for physicians about prescribing:
For patients with cancer: ESAs should only be used to treat anemia caused by chemotherapy—not to treat anemia from any other cause. After chemotherapy is finished, ESAs should no longer be used. Risks of tumor progression and decreased survival were noted in some clinical trials. The FDA strongly recommends that healthcare professionals discuss these risks with their patients before this therapy is started.
For anemic patients with chronic renal failure: Treat with the lowest level of the drug which will maintain hemoglobin levels within the target range of less than 12 g/dL. The established goal for this group is to maintain hemoglobin between 10-12 g/dL, because the risk for death and serious cardiovascular events increases when higher hemoglobin levels are achieved on ESA therapy. Further, it’s recommended that ESA therapy be discontinued if the patient’s hemoglobin levels remain so low that blood transfusions are still required.
What the FDA recommends for physicians and other healthcare professionals to discuss with their patients:
1. The primary goal of treatment with erythropoiesis stimulating agents (ESA) is to increase the number of red blood cells in order to avoid receiving blood transfusions.
2. These medications require at least two weeks of treatment before there is an increase in the number of red blood cells, and the dose may be adjusted periodically, but not more often than every four weeks.
3. ESAs increase the patient’s chance of blood clots and the risk of dying may be greater in certain circumstances.
4. Patients should keep appointments for blood tests so hemoglobin levels can be monitored.
5. Patients should monitor their blood pressure and call their healthcare provider for changes outside of the range that has been established for them.
6. Call the healthcare provider if they experience any of the following symptoms:
What the FDA wants patients to know about treatment with Aranesp, Epogen and Procrit . . .
Patients with cancer who are currently using or considering the use of an ESA should know the following:
• ESAs may shorten your survival time or may cause your tumors to grow faster.
• ESAs should only be used to treat anemia caused by chemotherapy and not other anemia from other causes in patients with cancer
• ESAs should not be used to treat the symptoms of anemia, such as fatigue or improve the quality of life in patients with cancer. The goal of treatment with ESAs is to avoid blood transfusions
• Treatment with an ESA should be stopped after you complete your course of chemotherapy.
Patients with chronic kidney failure (this includes both patients on dialysis and those not on dialysis) who are currently using an ESA should know the following:
• Your hemoglobin level should be checked regularly to make sure it stays between 10 and 12 g/dL.
• ESAs can increase your chance of heart attack, stroke, blood clots, heart failure, and death when they are given to maintain higher hemoglobin levels.
• If you are not responding to treatment with an ESA (your hemoglobin levels are not increasing) ask your doctor if you need to be checked for other causes of anemia.
Report Adverse Reactions to the FDA: Healthcare professionals are to report adverse and unexpected reactions with these meds to the FDA MedWatch reporting program online or by phone: 1-800-332-1088.
Links to more information about ESAs:
• Comprehensive information about ESAs from the U.S. Centers for Medicaid and Medicare Services: www.cms.hhs.gov/determinationprocess/downloads/id203d.pdf
• Kidney Disease and Anemia: http://kidney.niddk.nih.gov/kudiseases/pubs/anemia/
• Anemia and Kidney Disease: http://www.aakp.org/aakp-library/Anemia-in-Chronic-Kidney-Disease/
• A plus: Anemia and Kidney Disease from Anemia.org: http://www.anemia.org/patients/information-handouts/kidney-disease/
• ESA use for anemia in cancer patients: http://www.medscape.com/viewarticle/571464
.(All rights reserved, Carolyn Cooper, MPH, RN, 2009) .. . .
• Aranesp (darbopoetin alfa)
• Epogen (epoetin alfa)
• Procrit (epoetin alfa)
• There are other brand names & epoetin variants marketed worldwide
The Good News First . . .
Twenty years ago we didn’t have synthetic medications to treat anemia. Depending on the cause anemia was often treated through diet, by administering supplementary iron or vitamin B12, and frequently, by blood transfusions. The 1980's was a decade of concern over the safety of our blood supply due to blood borne pathogens such as Hepatitis B and C and the HIV virus. New technologies in recombinant DNA allowed science to explore and develop innovative alternative therapies.
In 1989, Epogen (epoetin alfa), the first of a class of drugs called erythropoiesis stimulating agents (abbreviated as “ESAs”), was approved by the FDA in the United States to treat patients suffering from anemia due to chronic kidney disease. Epogen was eventually joined by similar ESAs called Aranesp and Procrit and treatment was eventually broadened to include patients suffering from anemia related to chemotherapy.
The benefit to both groups was that they no longer needed to rely on frequent blood transfusions to treat their anemia. ESAs directly influence the body to speed up the production of its own red blood cells by introducing a synthetic version of the hormone erythropoietin. Erythropoietin is a chemical messenger of sorts with the specific mission of instructing our bone marrow to produce more red blood cells. Epogen, Aransep, and Procrit are easily given by a simple injection under the skin from one to three times per week.
So what exactly is anemia? Anemia results when we don’t have enough healthy red blood cells called erythrocytes circulating in our bloodstream. Healthy red blood cells are vital; they carry a protein called hemoglobin which picks up molecules of oxygen from our lungs and delivers it to the tissues throughout our body. We don’t store oxygen in our body but we use it continuously, and our body’s demand for oxygen is constant as oxygen molecules literally fuel every basic function that each cell in our body must perform.
Symptoms of Anemia. Moderate to severe anemia can cause symptoms of weakness, fatigue, shortness of breath, rapid/irregular heartbeat and pale skin. Milder or chronic anemia may cause subtle symptoms or no symptoms at all.
Erythropoietin. This hormone is a chemical messenger with several functions relating to the manufacture of red blood cells, preserving their lifespan in the body, and enhancing the growth of blood vessels. As we develop before birth, erythropoietin is active within our livers. After we are born, erythropoietin is manufactured and released by cells in the kidney.
Kidneys and Anemia. People often don’t think of a relationship between the kidneys and anemia, but when you carefully consider it, it makes sense for the kidney to have this function. Like a waste-water treatment plant adds chemicals based on the scientific observations of the plant technicians, the kidneys have specialized cells that detect decreased oxygen levels in the blood circulating through them, and as a result, these specialized cells release erythropoietin to enhance red blood cell formation and longevity. If the kidneys become diseased and fail, this system of checks and balances is impaired or lost. When ESAs, or synthetic erythropoietin, was first introduced in 1989, the drug was intended specifically for the benefit of patients in kidney failure.
Chemotherapy and Anemia. Cancer cells are bizarre mutant cells that divide rapidly. therefore, malignant tumors can grow large very quickly. The goal of chemotherapy is to target those rapidly-dividing bizarre cells and kill them. Other “good” rapidly-dividing cells in our body get caught in the cross-fire and are also damaged by chemo drugs. Hair is lost when rapidly-dividing cells in the roots are targeted by the chemo drugs. Other fast-growing cells affected by chemotherapy are in the digestive tract; that’s why mouth sores, nausea, and vomiting are a common consequence of chemo. The body’s rapidly dividing blood cells (red cells, white cells, and platelets) are also among the good cells that fall prey to chemotherapy. The anemia that results from chemotherapy is not caused by a lack of erythropoietin, but ESAs were approved by the FDA in 1993 to treat anemia to reduce the amount of blood transfusions necessary for patients suffering from chemotherapy-induced anemia.
Sobering News about ESAs . . .
All medications have both benefits and risks. In the U.S. the FDA places "black box warnings" on the medication labels and inserts of drugs when research suggests there is a risk of serious adverse effects. The first black box warning for ESAs appeared in March of 2007. Eight months later in November 2007, the black box warning was emphatically strengthened by the FDA.
Both the chronic renal failure and chemotherapy patients were found to have some increased risks when using ESAs. Patients with certain types of cancer were found to be at risks of tumor progression and decreased survival when taking ESAs to increase red blood cell production. Chronic renal failure patients were found to be at increased risk of developing heart attack, stroke, blood clots, heart failure and death if their ESA dose was high enough to cause them to make more than recommended number of red blood cells.
The FDA’s guidance to physicians was very specific on the recommended dosage to achieve good results without increasing patients’ risks for a bad outcome. Further, their guidance suggested that physicians specifically discuss the risks and benefits of these medications with their patients.
What’s Inside the Black Box . . . guidance for physicians about prescribing:
For patients with cancer: ESAs should only be used to treat anemia caused by chemotherapy—not to treat anemia from any other cause. After chemotherapy is finished, ESAs should no longer be used. Risks of tumor progression and decreased survival were noted in some clinical trials. The FDA strongly recommends that healthcare professionals discuss these risks with their patients before this therapy is started.
For anemic patients with chronic renal failure: Treat with the lowest level of the drug which will maintain hemoglobin levels within the target range of less than 12 g/dL. The established goal for this group is to maintain hemoglobin between 10-12 g/dL, because the risk for death and serious cardiovascular events increases when higher hemoglobin levels are achieved on ESA therapy. Further, it’s recommended that ESA therapy be discontinued if the patient’s hemoglobin levels remain so low that blood transfusions are still required.
What the FDA recommends for physicians and other healthcare professionals to discuss with their patients:
1. The primary goal of treatment with erythropoiesis stimulating agents (ESA) is to increase the number of red blood cells in order to avoid receiving blood transfusions.
2. These medications require at least two weeks of treatment before there is an increase in the number of red blood cells, and the dose may be adjusted periodically, but not more often than every four weeks.
3. ESAs increase the patient’s chance of blood clots and the risk of dying may be greater in certain circumstances.
4. Patients should keep appointments for blood tests so hemoglobin levels can be monitored.
5. Patients should monitor their blood pressure and call their healthcare provider for changes outside of the range that has been established for them.
6. Call the healthcare provider if they experience any of the following symptoms:
- Pain and/or swelling in the legs
- Worsening in shortness of breath
- Increases in blood pressure
- Dizziness or loss of consciousness
- Extreme tiredness
- Blood clots in hemodialysis vascular access ports
What the FDA wants patients to know about treatment with Aranesp, Epogen and Procrit . . .
Patients with cancer who are currently using or considering the use of an ESA should know the following:
• ESAs may shorten your survival time or may cause your tumors to grow faster.
• ESAs should only be used to treat anemia caused by chemotherapy and not other anemia from other causes in patients with cancer
• ESAs should not be used to treat the symptoms of anemia, such as fatigue or improve the quality of life in patients with cancer. The goal of treatment with ESAs is to avoid blood transfusions
• Treatment with an ESA should be stopped after you complete your course of chemotherapy.
Patients with chronic kidney failure (this includes both patients on dialysis and those not on dialysis) who are currently using an ESA should know the following:
• Your hemoglobin level should be checked regularly to make sure it stays between 10 and 12 g/dL.
• ESAs can increase your chance of heart attack, stroke, blood clots, heart failure, and death when they are given to maintain higher hemoglobin levels.
• If you are not responding to treatment with an ESA (your hemoglobin levels are not increasing) ask your doctor if you need to be checked for other causes of anemia.
Report Adverse Reactions to the FDA: Healthcare professionals are to report adverse and unexpected reactions with these meds to the FDA MedWatch reporting program online or by phone: 1-800-332-1088.
Links to more information about ESAs:
• Comprehensive information about ESAs from the U.S. Centers for Medicaid and Medicare Services: www.cms.hhs.gov/determinationprocess/downloads/id203d.pdf
• Kidney Disease and Anemia: http://kidney.niddk.nih.gov/kudiseases/pubs/anemia/
• Anemia and Kidney Disease: http://www.aakp.org/aakp-library/Anemia-in-Chronic-Kidney-Disease/
• A plus: Anemia and Kidney Disease from Anemia.org: http://www.anemia.org/patients/information-handouts/kidney-disease/
• ESA use for anemia in cancer patients: http://www.medscape.com/viewarticle/571464
.(All rights reserved, Carolyn Cooper, MPH, RN, 2009) .. . .
Friday, May 08, 2009
Fentanyl Transdermal Patches for Severe, Chronic Pain
A few days ago an elderly cancer patient was admitted to one of my rooms directly from the doctor's office for management of severe, chronic cancer-related pain. She rated her pain at "more than 10 of 10" on the pain scale. I'm always quick to give pain medication, but in this case we had no doctor's orders for one thing, and the supplies to access the patient's IV port-a-cath site (that's the same thing as an infus-a-port) hadn't arrived yet from the distant central supply department. Despite her pain, it was reassuring to review her home medication list and see that she had listed the Fentanyl transdermal pain patch among her medications. (Duragesic is a well-known brand-name for the Fentanyl patch.) The strong medication released from the patch on a slow, continuous basis is absorbed through the skin and provides great pain relief to most patients. Later in my admission assessment I asked her specific questions about the last time she took her home medications in order to complete the medication reconciliation process. It turned out that although the patient had filled the Fentanyl patch prescription, she had never used any of them.
My patient told me that after filling the Fentanyl patch prescription, she happened to catch an attorney's television commercial which warned about using Fentanyl patches. "The lawyer said those patches are 80 times more powerful than morphine, and they can kill a person." Unfortunately, my patient suffered quite a bit of intense pain and ended up admitted to the hospital due to that frightening television commercial. It's true that the Fentanyl is a MUCH stronger pain medication than morphine (about 100 times stronger), and certain circumstances related to this medication have come under well-deserved scrutiny in recent years--see FDA's 2007 Fentanyl Advisory--but with proper safeguards, this medication is both safe and very effective.
Some generic versions of the Fentanyl patch of the dosage 25 mcg/hr were recalled in 2008; check this list to learn more about the affected lots. The damaged patches released the pain medication too quickly, therefore putting patients at risk for an accidental overdose which could have caused them to breathe way too slowly--or not at all--due to oversedation.
I'll probably come back to tweak this blog entry later. For now, I want to point the reader to the patient information guide, instructions for use, and the "black box warning" for the Duragesic Fentanyl Patch.
The following "Important Safety Information" can be read in its entirety at the Duragesic site.
Here are some of the key points you need to know about using the (Fentanyl transdermal system) with my own bold/italics added to emphasize certain points.
My patient told me that after filling the Fentanyl patch prescription, she happened to catch an attorney's television commercial which warned about using Fentanyl patches. "The lawyer said those patches are 80 times more powerful than morphine, and they can kill a person." Unfortunately, my patient suffered quite a bit of intense pain and ended up admitted to the hospital due to that frightening television commercial. It's true that the Fentanyl is a MUCH stronger pain medication than morphine (about 100 times stronger), and certain circumstances related to this medication have come under well-deserved scrutiny in recent years--see FDA's 2007 Fentanyl Advisory--but with proper safeguards, this medication is both safe and very effective.
Some generic versions of the Fentanyl patch of the dosage 25 mcg/hr were recalled in 2008; check this list to learn more about the affected lots. The damaged patches released the pain medication too quickly, therefore putting patients at risk for an accidental overdose which could have caused them to breathe way too slowly--or not at all--due to oversedation.
I'll probably come back to tweak this blog entry later. For now, I want to point the reader to the patient information guide, instructions for use, and the "black box warning" for the Duragesic Fentanyl Patch.
The following "Important Safety Information" can be read in its entirety at the Duragesic site.
Here are some of the key points you need to know about using the (Fentanyl transdermal system) with my own bold/italics added to emphasize certain points.
- It is used to manage constant moderate to severe chronic pain that needs to be treated around the clock which cannot be treated by: combination narcotic, short-acting, or non-narcotic pain treatment products.
- It should only be used by people who are receiving or have developed a tolerance to pain therapy with products known as opioids. It should not be used if you have pain that will go away in a few days, such as pain from surgery, medical or dental procedures, or short-lasting conditions.
- One serious important side effect is slow, shallow, and/or difficulty in breathing, if the dose is too high. This sometimes happens the first time someone uses the product, so they should be watched more closely during the first 3 days of treatment.
- It can be abused in ways similar to other legal or illegal pain products. Care should be taken in storing this medication.
- It is a thin, adhesive, rectangular patch that is worn on your skin and delivers a strong pain-relieving medicine called Fentanyl through the skin and into the bloodstream. Using damaged patches can change the amount that is absorbed and cause too much medicine to be absorbed through the skin that can cause serious and sometimes fatal breathing problems.
- Do not combine with alcohol or other CNS depressants (e.g., sleep medications, tranquilizers) because dangerous additive effects may occur, resulting in serious injury or death.
- Avoid exposing the Fentanyl application site and surrounding area to direct external heat sources, such as heating pads or electric blankets, heat or tanning lamps, saunas, hot tubs, and heated water beds, while wearing the system. Avoid taking hot baths or sunbathing. There is a potential for temperature-dependent increases in Fentanyl released from the system resulting in possible overdose and death.
- Keep patches (new and used) out of the reach of children and others for whom Fentanyl was not prescribed. A considerable amount of active Fentanyl remains in the patch even after it has been used as directed. Accidental or deliberate application or ingestion by a child or adolescent will cause respiratory depression that could result in death.
- For more information about DURAGESIC® Fentanyl patches, talk to your doctor or call 1-800-526-7736, 9:00 AM - 5:00 PM (EST), Monday through Friday.
For additional information, here's a link to an FDA article, Proper Use of Fentanyl Pain Patches.
. . . .
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