Citation

Faust AC, Terpolilli R, Hughes DW. Case Rep. Med. 2011; 2011.

Copyright

(Copyright © 2011, Hindawi Publishing)

DOI

10.1155/2011/495938

PMID

unavailable

Abstract

PURPOSE. Fentanyl is available as a transdermal system for the treatment of chronic pain in opioid-tolerant patients; however, it carries a black box warning due to both the potency of the product and the potential for abuse. In this report, we describe a case of transbuccal and gastrointestinal ingestion of fentanyl patches and the management of such ingestion. Summary. A 32-year-old man was brought to the emergency department (ED) via emergency medical services for toxic ingestion and suicide attempt. The patient chewed and ingested two illegally purchased transdermal fentanyl patches. In the ED, the patient was obtunded, dizzy and drowsy. Initial vital signs showed the patient to be afebrile and normotensive with a heart rate of 63, respiratory rate of 16, and oxygen saturation of 100 on 2 liters nasal cannula after administration of 2 milligrams of intravenous naloxone. The patient was treated with whole bowel irrigation and continuous intravenous naloxone infusion for approximately 48 hours without complications.

CONCLUSION. Despite numerous case reports describing oral ingestion of fentanyl patches, information on the management of such intoxication is lacking. We report successful management of such a case utilizing whole bowel irrigation along with intravenous push and continuous infusion naloxone. © Copyright 2011 Andrew C. Faust et al.

Language: en

Keywords

adult; human; mental health; naloxone; male; case report; bipolar disorder; fentanyl; suicide attempt; intoxication; article; mental disease; priority journal; opiate; alprazolam; drowsiness; ingestion; methamphetamine; benzodiazepine; heart rate; opiate addiction; intestine lavage; bradycardia; blood pressure; dizziness; oxygen saturation; drug dose titration; medical history; arousal; continuous infusion; transdermal patch; breathing rate