Citation

Sindali K, Sherry K, Sen S, Dheansa B. J. Med. Case Reports 2012; 6(1): 220.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1752-1947-6-220

PMID

22835002

Abstract

INTRODUCTION: Fentanyl transdermal patches have been widely used in the treatment of chronic pain and inpalliative care settings since 1991 in cases where prolonged opioid use is often necessary.Transdermal drug delivery is deemed safe and effective with the advantages of delivering asteady dose of the drug and improving patient compliance due to its ease of use. However,intentional and unintentional misuse and overdose using transdermal opioid patches has beenwidely reported in the literature. CASE PRESENTATION: We describe the case of a 77-year-old Caucasian woman who developed severe opioidtoxicity while sun tanning, likely due to altered fentanyl transdermal patch function in aheated environment. As a result of prolonged sun exposure due to an opioid-induced comashe then sustained hyperthermia and severe burns to her abdomen and lower limbs. Thisinadvertent fentanyl overdose necessitated initial treatment in intensive care and follow oncare in a specialist burn unit. CONCLUSION: Patients who are using fentanyl patches and their relatives should be educated about how touse the patch safely. Healthcare practitioners should warn patients about the possibility ofoverdosing on transdermally delivered drugs if used incorrectly. They should avoid strenuousactivities and external heat sources such as warming blankets, hot water bottles, saunas, hottubs or sunbathing and should seek medical attention if they develop a fever. Additionally,any burns sustained in the context of altered consciousness levels such as in this case withopioid overdose should raise suspicion about a potential deeper burn injury than is usuallyobserved.

Language: en