Tuesday, December 1, 2009

Fentanyl poisoning

In July, Jeffery Scott Swaim, 40, was found in a bus seat and not breathing, according to the article, which also stated that New Hanover Regional Medical Center doctors found a pain patch in his mouth.An autopsy confirmed Friday he died from acute Fentanyl poisoning. Swaim’s family is reportedly thinking about suing the state psychiatric facility, which gave Swaim the prescription painkiller, the article stated. Apparently Fentanyl is becoming an increasingly common source of prescription drug abuse with abusers cutting up and chewing the pain patches to get high.

The federal Food and Drug Administration has put out warnings after reports of deaths and life-threatening side effects when the patches are used incorrectly or inappropriately prescribed. Because of the strong narcotics, the patches are supposed to be for patients who have become tolerant to other strong opioid narcotic pain meds and who have chronic pain.

Fentanyl — brand names include Actiq, Duragesic, Fentora, Onsolis, Sublimaze[and Instanyl — is a synthetic primary μ-opioid agonist commonly used to treat chronic breakthrough pain and is commonly used in pre-procedures. It is approximately 100 times more potent than morphine, with 100 micrograms of fentanyl approximately equivalent to 10 mg of morphine and 75 mg of pethidine (meperidine) in analgesic activity. It has an LD50 of 3.1 milligrams per kilogram in rats, 0.03 milligrams per kilogram in monkeys, and an undetermined LD50 in humans.

Fentanyl was first synthesized by Dr. Paul Janssen in 1960following the medical inception of meperidine several years earlier. Janssen developed Fentanyl by assaying analogues of the structurally-related drug meperidine for its opioid activity.The widespread use of fentanyl triggered the production of fentanyl citrate, which entered the clinical practice as a general anaesthetic under the trade name Sublimaze in the 1960s. Following this, many other fentanyl analogs were developed and introduced into the medical practice, including Sufentanil, Alfentanil, Remifentanil, and Lofentanil.

In the mid 1990s, fentanyl saw its first widespread palliative use with the clinical introduction of the Duragesic patch, followed in the next decade by the introduction of the first quick-acting prescription formations of fentanyl for personal use, the Actiq lollipop and Fentora buccal tablets. Through the delivery method of transdermal patches, fentanyl is currently the most widely used synthetic opioid in clinical practice, with several new delivery methods currently in development.Fentanyl is classified as a Schedule II drug in the United States due to its potential for abuse.