Presentation
Further history upon the patient's recovery revealed exposure to snorted fentanyl powder immediately prior to presentation. Diffuse alveolar hemorrhage is a potential, though rare, presentation of opioid intoxication. [ncbi.nlm.nih.gov]
Entire Body System
-
Edema of Lower Extremity
In one subject, infusion of IT saline resulted in faster resolution of peripheral edema. Peripheral lower extremity edema may occur in patients treated with IT infusion of hydromorphone or morphine, even at low doses. [ncbi.nlm.nih.gov]
Gastrointestinal
-
Nausea
The most common AEs were somnolence, nausea, and vomiting. All AEs were mild or moderate in severity. Doses at 400, 600, and 800 mcg were associated with nausea and vomiting, requiring pharmacologic intervention. [ncbi.nlm.nih.gov]
-
Vomiting
The most common AEs were somnolence, nausea, and vomiting. All AEs were mild or moderate in severity. Doses at 400, 600, and 800 mcg were associated with nausea and vomiting, requiring pharmacologic intervention. [ncbi.nlm.nih.gov]
Gaskey NJ, Ferriero L, Pournaras L, Seecof J "Use of fentanyl markedly increases nausea and vomiting in gynecological short stay patients." AANA J 54 (1986): 309-11 36. [web.archive.org]
-
Chronic Abdominal Pain
A 42-year-old man with lymphoma was started on transdermal fentanyl therapy while hospitalized for chronic abdominal pain. The patient was last seen awake 1.3 h prior to being found apneic and cyanotic. [ncbi.nlm.nih.gov]
Cardiovascular
-
Thrombosis
Magnetic Resonance Imaging (MRI) with diffuse weighed scan, duplex ultrasound for deep vein thrombosis, carotid artery Doppler, electroencephalography (EEG), and trans-thoracic echocardiography were all normal. [ncbi.nlm.nih.gov]
Eyes
-
Miosis
Fentanyl, fentanyl analogs and other novel synthetic opioids are all full agonists of varying potencies at the μ-opioid receptor, leading to typical clinical effects of miosis and respiratory and central nervous system depression. [ncbi.nlm.nih.gov]
[…] subcutaneous tissue disorders Erythema 1 The following adverse reactions occurred in adult and pediatric patients with an overall frequency of 1% and are listed in descending frequency within each System/Organ Class: Cardiac disorders: cyanosis Eye disorders: miosis [rxlist.com]
Kappa 1: Spinal analgesia and miosis. Kappa 2: Dysphoria and psychotomimesis. Kappa 3: Supraspinal analgesia. Chronic opioid users develop tolerance to the analgesic and euphoric effects, but not to the respiratory depression effects. [acilbook.com]
Fentanyl may also produce other signs and symptoms characteristic of narcotic analgesics including euphoria, miosis, bradycardia and bronchoconstriction. [web.archive.org]
[…] specific receptor binding sites in the CNS and other tissues; opiate receptors are concentrated in the limbic system, thalamus, striatum, hypothalamus, midbrain, and spinal cord. f Agonist activity at the opiate μ- or κ-receptor can result in analgesia, miosis [drugs.com]
-
Transient Blindness
Transient blindness in a preeclamptic patient secondary to cerebral edema. Hawaii Med J. 1996; 55 :116–7. [ PubMed ] [ Google Scholar ] 7. Williams K, McLean C. Maternal cerebral vasospasm in eclampsia assessed by transcranial Doppler. [ncbi.nlm.nih.gov]
Transient blindness in a preeclamptic patient secondary to cerebral edema. Hawaii Med J 1996;55:116-7. [ PUBMED ] 7. Williams K, McLean C. Maternal cerebral vasospasm in eclampsia assessed by transcranial Doppler. [dx.doi.org]
Face, Head & Neck
-
Facial Numbness
Although intrathecal opioids are safe for both the mother and fetus; some unusual complications such as dysphagia alone or associated with facial numbness, aphasia, have been reported. [ncbi.nlm.nih.gov]
Neurologic
-
Neglect
Communities say their budgets are being strained by the additional needs — for increased police and medical care, for widespread naloxone distribution and for a stronger foster care system that can handle the swelling number of neglected or orphaned children [web.archive.org]
-
Neurologic Manifestation
Manifestations Signs and Symptoms Fentanyl Analgesics, Opioid Narcotics Central Nervous System Depressants Physiological Effects of Drugs Analgesics Sensory System Agents Peripheral Nervous System Agents Adjuvants, Anesthesia Anesthetics, Intravenous [clinicaltrials.gov]
-
Hand Tremor
A 79 year old male patient, scheduled for hernia repair, and with a preoperative physical examination of slight hand tremor, received a bolus of 100 mcg (1.2 mcg/kg) fentanyl as primary agent for induction. [ncbi.nlm.nih.gov]
-
Trigeminal Neuralgia
Others have estimated an incidence of 4 in 100,000 per year ( Katusic 1991 ; Rappaport 1994 ) for trigeminal neuralgia, and of 12.6 per 100,000 person‐years for trigeminal neuralgia and 3.9 per 100,000 person‐years for PHN in a study of facial pain in [doi.org]
Workup
The plant material (total net mass 42.74 kilograms) was frozen upon arrival at the laboratory to prevent conversion of cathinone to cathine while awaiting workup. [web.archive.org]
Treatment
CONCLUSION: Oxycodone treatment before tracheal extubation reduced cough response and was as effective as fentanyl treatment for improving extubation quality. [ncbi.nlm.nih.gov]
Prognosis
When clinicians think of cancer patients with severe pain, they typically think of patients with terminal conditions and a prognosis measured in months or less. [doi.org]
Etiology
Despite being reported since 1943 as well as being the subject of a large body of literature since that time, no consensus has been reached regarding the etiology of opioid induced hyperalgesia (OIH). [ncbi.nlm.nih.gov]
Epidemiology
Providence, RI 02903, USA. 3 Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02903, USA. 4 Center for Health Equity Research, University of North Carolina at Chapel Hill, 335 S. [ncbi.nlm.nih.gov]
[…] to lecture, threaten, or judge them Discuss peer pressure and ways to say no to drugs Resources Fentanyl drug labs: Awareness for landlords and rental services Opioids Fentanyl seized in 2016 RCMP Centre for Youth Crime Prevention Canadian Community Epidemiology [rcmp-grc.gc.ca]
Pathophysiology
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Fentanyl is an extremely fast acting synthetic opioid related to the phenylpiperidines.(1,2) It is available in injectable as [mayomedicallaboratories.com]
The pathophysiology is unclear. Patients should be observed for 4 to 6 hours after overdose to evaluate for hypoxia and/or the development of acute lung injury. [acilbook.com]
Prevention
Focusing on the prevention of medical errors, Oleszczuk and his colleagues at FDA report that infants and toddlers have unique risks of accidental exposure to fentanyl. [web.archive.org]
The use of fentanyl around the end of surgery has been proposed to prevent emergence agitation. [ncbi.nlm.nih.gov]
The third drug to be injected — the paralytic agent — would have prevented Mr. Dozier from writhing on the gurney or showing any outward signs of pain, even as he suffered an agonizing death, the critics added. [nytimes.com]