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Fentanyl is a potent, synthetic opioid pain medication with a quick onset and short duration of action. Fentanyl is 70 to 110 times more potent than morphine, but some fentanyl analogs, which are designed to resemble the pharmacological effects of the original drug, maybe as much as 9,999 times more potent than morphine.
Paul Janssen in 1960 made the first fentanyl following the medical inception of Demerol several years earlier. The widespread use of fentanyl triggered the production of fentanyl citrate which entered medical use as a general anesthetic under the trade name Sublimaze in the 1960s.
In the 1990s, fentanyl was introduced for pain relief use with the fentanyl patch, followed in the next decade by the introduction of the fentanyl lollipop, dissolving tablets, and sublingual spray which is absorbed through the tissues inside the mouth. Since 2012, fentanyl is the most widely used synthetic opioid in medicine and 1700 kilograms is consumed globally.
Fentanyl is also used as a recreational drug, leading to thousands of overdose deaths from 2000 to 2017.
Uses Of Fentanyl
Intravenous fentanyl is often used for anesthesia(used along with propofol) and pain-relieving. It is often used in the management of chronic pain including cancer pain. It is also administered in combination with a benzodiazepine, such as midazolam, to produce sedation for procedures such as endoscopy, cardiac catheterization, and oral surgery.
Fentanyl transdermal patches (Duragesic) are used in chronic pain management. The patches work by slowly releasing fentanyl through the skin into the bloodstream over 48 to 72 hours, allowing for long-lasting pain management. Dosage is based on the size of the patch, since, in general, the transdermal absorption rate is constant at a constant skin temperature. The rate of absorption is dependent on a number of factors. Body temperature, skin type, amount of body fat, and placement of the patch can have major effects. The different delivery systems used by different makers will also affect individual rates of absorption. Under normal circumstances, the patch will reach its full effect within 12 to 24 hours; thus, fentanyl patches are often prescribed with a fast-acting opiate (such as morphine or oxycodone) to handle breakthrough pain. It is unclear if fentanyl gives pain relief to people with neuropathic pain.
Fentanyl lozenges (Actiq) are a solid formulation of fentanyl citrate on a stick in the form of a lollipop that dissolves slowly in the mouth for transmucosal absorption. It has also been used for breakthrough pain for patients with nonmalignant (not cancer-related) pain, but this application is controversial. These lozenges are intended for opioid-tolerant individuals and are effective in treating breakthrough cancer pain. It is most effective when the lozenge is consumed within 15 minutes. About 25 percent of the drug is absorbed through the oral mucosa, resulting in a fast onset of action, and the rest is swallowed and absorbed in the small intestine, acting more slowly. The lozenge is less effective and acts more slowly if swallowed as a whole, as despite good absorbance from the small intestine there is extensive first-pass metabolism, leading to an oral bioavailability of about 33 percent as opposed to 50 percent when used correctly. Buy Fentanyl Powder Online
Fentanyl’s most common side effects include diarrhea, nausea, constipation, dry mouth, somnolence, confusion, weakness, sweating, and less frequently abdominal pain, headache, fatigue, anorexia and weight loss, dizziness, nervousness, hallucinations, anxiety, depression, flu-like symptoms, indigestion, shortness of breath, hypoventilation, apnea, and urinary retention. Fentanyl use has also been associated with aphasia. Fentanyl may produce more prolonged respiratory depression than other opioid analgesics.
The patches should be kept away from children, who are most at risk from a fentanyl overdose.
Death from fentanyl overdose was declared a public health crisis in Canada in September 2015, and it continues to be a significant public health issue in 2016, deaths from fatal fentanyl overdoses in British Columbia, Canada, averaged two persons per day.
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