China
Africa
Explore chapters and articles related to this topic
Substance Abuse during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Methadone is a synthetic opioid analog and is used as an alternative to heroin in abuse, and as a treatment. Fentanyl is sometimes used to cut heroin. Fentanyl is 40 to 100 times more potent than opiates, and are associated with a high proportion of opiate overdose deaths. Fortunately, naloxone is the antidote to fentanyl. An intranasal form is available for use in emergency out of hospital resuscitation.
Obstetric Analgesia
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Fentanyl is a rapid-acting opioid analgesic and is used as an adjuvant to the local anaesthetic agent for the neuraxial blockade. It is commonly used in epidural preparations in a concentration of 2 mcg/ml and has a duration of action of 1 hour.
Anesthesia and analgesia in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Fentanyl is a potent synthetic opioid. The potency relative to morphine is 100 to 1. It is most often administered IV and has a rapid onset of less than 1 minute. It has a relatively short duration of action and requires frequent dosing (18). Because of its short duration of action, it is titratable and hence it is attractive when administered as patient-controlled analgesia (PCA). Because its potency is much greater than morphine and meperidine, it has a greater potential for causing severe respiratory depression. Patients receiving fentanyl should be closely monitored. Nevertheless, studies have demonstrated a lesser degree of neonatal effects with the use of fentanyl than with the use of meperidine or morphine (24,25).
Prehospital Buprenorphine Treatment for Opioid Use Disorder by Paramedics: First Year Results of the EMS Buprenorphine Use Pilot
Published in Prehospital Emergency Care, 2023
H. Gene Hern, Vanessa Lara, David Goldstein, M. Kalmin, S. Kidane, S. Shoptaw, Ori Tzvieli, Andrew A. Herring
Since 2011, death by overdose is the leading cause of accidental death in the United States; two-thirds of all overdose-related deaths involve opioids (5, 6). According to recent data from the Centers for Disease Control, in the 12 months ending in October 2021, the number of overdose deaths increased to more than 100,000. This estimate represents the highest number of deaths ever recorded in a 12-month period, with ongoing dramatic increases year after year (7). Fentanyl and its analogues have been the largest drivers of overdose deaths in the United States (8). Fentanyl has several characteristics that put patients at higher risk for fatal overdose. Primarily, it is highly lipophilic with more rapid onset than even injected heroin, substantially reducing the time from use to critical respiratory depression. Potency is not easily determined by the appearance and can vary widely between batches and dealers such that regular fentanyl users may still overdose with the “same” amount they might regularly use (9, 10). Hence, as fentanyl becomes the most prevalent illicit opioid in use, overdoses have predictably increased. Consequently, the ideal public health response should focus not only on those at risk for overdose, but also overdose survivors.
Predicting transdermal fentanyl delivery using physics-based simulations for tailored therapy based on the age
Published in Drug Delivery, 2022
Flora Bahrami, René Michel Rossi, Thijs Defraeye
Severe chronic pain is a frequent symptom in cancer patients, and about 70–80% of the patients in advanced cancer stages deal with such pain (Caraceni et al., 2012). However, proper pain treatment is challenging, considering the complex nature of pain and differentiated actions of opioids (Andresen et al., 2011). Untreated or poorly-treated pain could be overwhelming for the patients and reduce their quality of life (Serlin et al., 1995). Fentanyl is clinically used to treat moderate-to-severe cancer pain. Fentanyl is a synthetic opioid that is used in cases where non-steroidal anti-inflammatory drugs (NSAIDs) are insufficient (Orsini et al., 2006). As an alternative to oral and parenteral delivery, transdermal fentanyl delivery (TDD) is a clinically-approved therapy, which is successful due to its low molecular weight, high potency, and lipid solubility of fentanyl. The key advantage of transdermal fentanyl delivery, besides simplicity and noninvasive delivery, is that it offers a controlled delivery of fentanyl and avoids the first-pass metabolism (Muijsers and Wagstaff, 2001; Marier et al., 2006).
“Narcan encounters:” overdose and naloxone rescue experiences among people who use opioids
Published in Substance Abuse, 2022
Linda S. Kahn, Monika Wozniak, Bonnie M. Vest, Cheryll Moore
Several participants attributed recent overdoses to the presence of fentanyl. Michael believed that fentanyl caused his overdose, and remarked, “It’s kind of how the heroin is nowadays,” noting that 10 years ago it was pure heroin, “but now it’s just this fentanyl crap.” Matthew’s post-overdose drug toxicology test revealed fentanyl and cocaine: “the drug test didn’t even come up for opioids…” Another participant, Steven, attributed two recent overdoses to fentanyl. He had returned to Western New York after spending time in the southern United States and remarked that in the South he was “getting pure heroin” but in Western New York “I’m assuming that was the fentanyl that was around, because …the fentanyl comes on really strong, so it shuts you down. And that’s not normal.” Interviewees distinguished fentanyl overdoses from other opioid overdose experiences, noting that fentanyl overdoses are characterized by the rapidity of blacking out.