Recurrent Respiratory Depression Associated with Fentanyl Transdermal Patch Gel Reservoir Ingestion
- 作者：Joseph L. D&rsquo ; Orazio ; MD&lowast ; ; &dagger ; ; ; Jason A. Fischel ; MD&dagger ;
- 关键词：fentanyl transdermal gel patch ; opioid abuse ; ingestions
- 刊名：Journal of Emergency Medicine
- 出版年：2012
- 期刊代码：156_07364679
- 类别：med
- 出版时间：May, 2012
- 卷：42
- 期：5
- 页码：543-548
- 文件大小：161 K
摘要
Background
Opioid abuse is common in the United States and is currently on the rise. Fentanyl transdermal patches (FTPs) have been on the market since 1991, and have recently become a popular source of opioids for abusers. There are currently two distinct FTP designs available on the market today; a gel reservoir system and a matrix construct. The gel reservoirs of FTPs contain massive amounts of fentanyl and are easily extractable for abuse. Ingesting the gel reservoir of an FTP is potentially lethal.Case Series
In this case series, 4 patients ingested the gel reservoir of an FTP and experienced severe and recurrent respiratory depression necessitating continuous naloxone infusions. All patients responded adequately to initial prehospital doses of naloxone (0.8-2 mg intravenous) but developed recurrent respiratory depression within 2 h of presentation to the hospital.
Conclusion
The gel reservoir of an FTP contains massive amounts of fentanyl. Ingestion of the gel may cause聽severe and recurrent respiratory depression necessitating repeated naloxone boluses, continuous naloxone infusion, and a prolonged observation period.