There have been no prior case reports of this occurring in palliative care, but the frequency of association of fentanyl with bradycardia in the anesthesia setting suggests it may be more common than realized. This case report describes a patient who developed severe bradycardia due to transdermal fentanyl. PMID:22114625Ĭase report of severe bradycardia due to transdermal fentanyl. The pharmacology and illicit use of fentanyl are also considered. Only one previously reported case of an individual chewing fentanyl patches was found in the literature no case reports were found where treatment involved titrating the patient onto methadone. The patient was successfully titrated onto methadone 30 mg. This case report discusses the clinical presentation and management of a patient presenting to substance misuse services reporting chewing fentanyl patches in addition to wearing them transdermally. Report of a patient chewing fentanyl patches who was titrated onto methadone Bioavailability of methadone was significantly higher than that of oxymorphone. Bioavailability was calculated as the ratio of the area under the time-concentration curve following buccal administration to that following IV administration, each indexed to the administered dose. Arterial blood was sampled immediately prior to drug administration and at various times up to 8 h thereafter. Morphine sulfate, 0.2 mg/kg IV or 0.5 mg/kg buccal methadone hydrochloride, 0.3 mg/kg IV or 0.75 mg/kg buccal hydromorphone hydrochloride, 0.1 mg/kg IV or 0.25 mg/kg buccal or oxymorphone hydrochloride, 0.1 mg/kg IV or 0.25 mg/kg buccal were administered. Buccal pH was measured prior to drug administration. Six healthy adult female spayed cats were used. This study characterized the bioavailability of these drugs following buccal administration to cats. Morphine, methadone, hydromorphone, and oxymorphone have a pKa between 8 and 9. It has been argued that absorption of buprenorphine through the buccal mucosa is high, in part due to its pKa of 8.24. Pypendop, B H Ilkiw, J E Shilo-Benjamini, Yīuccal administration of buprenorphine is commonly used to treat pain in cats. © 2016 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.īioavailability of morphine, methadone, hydromorphone, and oxymorphone following buccal administration in cats. The results of this study do not allow us to predict the usefulness of these drugs for providing analgesia in clinical patients. At the doses used in this study, IV administration of methadone and hydromorphone, and buccal administration of methadone resulted in transient thermal antinociception. IV administration of morphine and oxymorphone, and buccal administration of morphine, hydromorphone and oxymorphone did not cause significant thermal antinociception. Buccal administration of methadone resulted in significant increases in thermal threshold, although no significant difference from baseline measurement was detected at any time point. Administration of methadone and hydromorphone IV resulted in significant increases in ΔT at 40 minutes after drug administration. The difference between thermal threshold and skin temperature (ΔT) was analyzed. Skin temperature and thermal threshold were measured in duplicate prior to drug administration, and at various times up to 8 hours after drug administration. All cats were administered all treatments. Morphine sulfate (0.2 mg kg -1 IV or 0.5 mg kg -1 buccal), methadone hydrochloride (0.3 mg kg -1 IV or 0.75 mg kg -1 buccal), hydromorphone hydrochloride (0.1 mg kg -1 IV or 0.25 mg kg -1 buccal) or oxymorphone hydrochloride (0.1 mg kg -1 IV or 0.25 mg kg -1 buccal) were administered. Six healthy adult female ovariohysterectomized cats weighing 4.5 ± 0.4 kg. To determine the effects of morphine, methadone, hydromorphone or oxymorphone on the thermal threshold in cats, following buccal and intravenous (IV) administration. Pypendop, Bruno H Shilo-Benjamini, Yael Ilkiw, Jan E Effect of morphine, methadone, hydromorphone or oxymorphone on the thermal threshold, following intravenous or buccal administration to cats.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |