Intravenous Fentanyl Kinetics

McClain, Deborah A.; Hug, Carl C.; Fairley, H. Barrie

doi:10.1097/00132586-198108000-00011

Cited by 50 publications

(76 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…60 Fentanyl is rapidly metabolized and eliminated almost exclusively by the liver with only 5%-10% excreted unchanged in the urine. 61 Its metabolites are considered to be inactive. However, the hepatic clearance and extraction of drugs can be inhibited by uremia.…”

Section: Fentanylmentioning

confidence: 99%

The Prevalence and Management of Chronic Pain in End-Stage Renal Disease

Davison

2007

Journal of Palliative Medicine

View full text Add to dashboard Cite

A growing body of literature has demonstrated that chronic pain is common for patients with end- stage renal disease (ESRD), is typically moderate or severe, and impacts virtually every aspect of health-related quality of life. Unfortunately, there is a lack of clinical and research focus in this area in nephrology and pain in ESRD is undertreated. This paper reviews the epidemiology of chronic pain in ESRD, discusses basic principles of pain assessment and management, and highlights some of the challenges in pain management in ESRD with the hope of guiding health professionals in the effective management of pain in patients with ESRD.

show abstract

Section: Fentanylmentioning

confidence: 99%

The Prevalence and Management of Chronic Pain in End-Stage Renal Disease

Davison

2007

Journal of Palliative Medicine

View full text Add to dashboard Cite

show abstract

“…For example, fentanyl has been shown to be rapidly metabolized hepatically and more than 60% has been shown to be recovered as inactive and non-toxic metabolites in 72 hours after administration. No dose adjustment is necessary in patients with varying degrees of renal impairment; furthermore, fentanyl has been found not to be dialyzable by hemodialysis [65]. Morphine is also extensively metabolized by the liver into morphine-6-glucuronide (M6G), which is a quantitatively minor but active metabolite that results from morphine biotransformation.…”

Section: Use Of Opioids In Cancer Patients With Renal Impairmentmentioning

confidence: 99%

Current concepts of pain management for cancer patients

2008

View full text Add to dashboard Cite

Pain management is one of the most important issues confronted when treating patients with malignant diseases. Since its release/publication in 1986, the World Health Organization's three-step analgesic ladder has helped to greatly improve pain management in cancer patients. However, many questions about this three-step analgesic ladder have been raised and its application in the clinical setting remains a controversial subject. This review article explores the frontline treatment of cancer pain with morphine and the different routes of fentanyl administration used in cancer pain management. The combination of multiple opiates/opioids has been shown to result in more effective cancer pain management; however, the exact benefits of such opiate/opioid combinations have yet to be established. This article also discusses recent advances in the topical application of morphine and in the combination of ketamine and morphine. It explores the updated treatment principles of neuropathic pain in advanced-stage cancer patients, which incorporate the use of anti-depressants, anti-convulsants, and opioids. Finally, this article reviews the available data and clarifies the general principles for using opioids in cancer patients with renal insufficiency. We hope that this information will be helpful in improving pain management in cancer patients and in facilitating further research.

show abstract

“…Fentanyl is a powerful opioid that could be an alternative to morphine in patients with renal failure because it has no active metabolites and less than 10% of the unchanged drug is excreted in the urine [30]. It is highly lipid-soluble and undergoes rapid redistribution; after an intravenous dose of fentanyl, there is a rapid onset but a short duration of action lasting only about 30 min [31].…”

Section: Fentanylmentioning

confidence: 99%

Contribution to variability in response to opioids

Hanks

Reid

2004

Support Care Cancer

View full text Add to dashboard Cite

Opioids are the oldest and most effective agents for the short- and long-term control of severe pain, particularly chronic cancer pain palliation. However, morphine and other opioids display wide variations in pharmacological efficacy and tolerability, and a significant number of patients are unable to achieve adequately controlled pain at doses that do not produce intolerable adverse effects. This article reviews factors that affect the efficacy and tolerability of opioid analgesics and clinical strategies for successful pain mangement.

show abstract

Intravenous Fentanyl Kinetics

Cited by 50 publications

References 0 publications

The Prevalence and Management of Chronic Pain in End-Stage Renal Disease

The Prevalence and Management of Chronic Pain in End-Stage Renal Disease

Current concepts of pain management for cancer patients

Contribution to variability in response to opioids

Contact Info

Product

Resources

About