Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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A Case of Fentanyl Toxicity with Misused Durogesic Transdermal Patch

Durogesic 부착포로 인한 fentanyl 중독 1례

  • Yun, Sung Hyun (Department of Emergency Medicine, College of medicine, Inha University) ;
  • Jung, Hyun Min (Department of Emergency Medicine, College of medicine, Inha University) ;
  • Kim, Ji Hye (Department of Emergency Medicine, College of medicine, Inha University) ;
  • Han, Seung Baik (Department of Emergency Medicine, College of medicine, Inha University) ;
  • Kim, Jun Sig (Department of Emergency Medicine, College of medicine, Inha University) ;
  • Paik, Jin Hui (Department of Emergency Medicine, College of medicine, Inha University)
  • 윤성현 (인하대학교 의과대학 응급의학교실) ;
  • 정현민 (인하대학교 의과대학 응급의학교실) ;
  • 김지혜 (인하대학교 의과대학 응급의학교실) ;
  • 한승백 (인하대학교 의과대학 응급의학교실) ;
  • 김준식 (인하대학교 의과대학 응급의학교실) ;
  • 백진휘 (인하대학교 의과대학 응급의학교실)
  • Received : 2013.05.23
  • Accepted : 2013.06.07
  • Published : 2013.06.13
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Abstract

Fentanyl, a synthetic, highly selective opioid ${\mu}$-receptor agonist, is 50 to 100 times more potent than morphine. The low molecular weight, high potency, great transdermal permeation rate and lipid solubility of fentanyl make it very suitable for transdermal administration. Durogesic is a novel matrix transdermal system providing continuous systemic delivery of fentanyl. In recently, there are many reports that misused or overused fentanyl transdermal patches result in severe intoxication of fentanyl. We present a case of fentanyl toxicity with misused durogesic transdermal patch and discuss the safe and appropriate application of the patches. In conclusion, fentanyl patches should be used in opioid tolerant patients and prescribed at the lowest possible dose and titrated upward as needed. All patients and their caregivers should be educated safe application of fentanyl patches and advised to avoid exposing the patches application site to direct external heat sources, such as heating pads, or electric blankets, heat lamps, sauna, hot tubs, and others. In addition, concomittant medications that affect fentanyl's metabolism should be avoided.

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