A patient using a fentanyl transdermal patch for pain control may develop toxic symptoms under a variety of circumstances that are preventable.
Risk factors for fentanyl toxicity in a patient treated with a fentanyl patch:
(1) The patient is not opioid tolerant.
(2) The patient and attendants are not familiar with the signs of fentanyl overdosage.
(3) The person is misusing the patch (chewing, trying to extract the drug, etc).
(4) The patch is being changed too often or more than 1 patch is being worn at the same time.
(5) The patch is exposed to heat after placement (warm bottle, heating pad, etc).
(6) The patient is taking a medication that interferes with fentanyl metabolism/elimination.
(7) The patient is taking other drugs that have additive effects.
(8) The prescribed dose is too high or advanced too aggressively.
Signs of fentanyl toxicity:
(1) altered, shallow, slow or troubled breathing
(2) bradycardia
(3) drowsiness
(4) cold, clammy skin
(5) trouble walking or talking
(6) confusion
(7) feeling faint or dizzy
