Two Cases of Fentanyl Intoxication Through Overusing Fentanyl Patch

Moon, Jeong Mi; Chun, Byeong Jo

Abstract

Fentanyl is a selective and pure agonist to the micron receptor and is about 100 times more potent than morphine. It has been used through intravenously to control acute pain, such as postopreative pain, for a long time. A transdermal fentanyl system, a fentanyl patch, composed of four layers of functional reserviors of fentanyl and one protective layer, delivers a constant amount of fentanyl to systemic circulation thorough passive diffusion for up to 3 days after application on the skin. Due to its pharmacokinetic properties, including delayed onset, relatively constant effect for 3 days, and to the relatively short duration and variable change of acute pain, we recommend that the transdermal fentanyl system should be used to control chronic pain in patients who do not response to lower analgesic agents. However, because of misperception of health care providers, its noninvasive and simple method of administration, and the absence of laws to regulate its usage, abuses of the transdermal fentanyl system have been reported a lot. In conclusion, we reported the cases of two patient who experienced fatal effects after abuse of fentanyl patch, we analyse the pharmacokinetic properties of the fentanyl patch and previous reported cases. We also discuss the appropriate use and regulation of the transdermal fentanyl system by primary health care provider.