Eli's Hospice Insider

Published on Fri Jan 16, 2009 PDF

This 2-point assessment can stave off problems.

Fentanyl patches can be an effective pain management approach. But you might improve outcomes by asking these two key questions before or when providing the medication.

1. Is the patient thin or febrile? Either condition can affect absorption of transdermal fentanyl, according to Mary Lynn McPherson, PharmD, BCPS, professor and vice chair in the Department of Pharmacy Practice and Science at the University of Maryland in Baltimore. Fentanyl is a very fat soluble drug, and thus may not work well for thin patients, although the mechanism for this isn't clearly understood, she says. On the other hand, if someone has a fever, he will absorb more of the medication, McPherson adds -- "that's true for any dermal application. The heat is going to make any drug come out of the patch more quickly."

2. Is the patient's pain stable? If not, McPherson advises against transitioning the person to transdermal fentanyl. "It's too difficult to chase a changing pain picture with a delivery system that takes three to six days to achieve a steady state."