Durogesic®
What is Durogesic®?
Durogesic® is the trade name under which the highly potent, synthetic analgesic (pain reliever) fentanyl is sold. Fentanyl is a pain reliever that is very similar to morphine in terms of pharmacological properties. However, compared to morphine, fentanyl is a hundred times more effective.
Indications
Fentanyl is mostly called anesthetic used in general anesthesia, during which it is usually combined with other preparations.
In the treatment very severe pain (e.g. tumor pain), fentanyl is also used (then as a pain plaster).
In the Emergency medicine Because of its high potency and immediate exposure, fentanyl is the standard analgesic for very severe pain (such as Burns, Polytrauma, etc.) applied.
Pharmacokinetics
Only the pharmaceutical fentanyl dihydrogen citrate or fentanyl citrate is used intravenous administration (e.g. as a syringe) occurs very quickly and after a bolus injection of 100 micrograms fentanyl the effect lasts for about 30 minutes on. Fentanyl mainly binds to the µ opioid receptors, but can also show agonistic affinity for the δ and κ opioid receptors.
How is Durogesic® used?
In the anesthesia is fentanyl as Solution for injection used. Another way of using fentanyl is as band Aid (so-called transdermal system). In this form it is then sold as "Durogesic TTS" or "Durogesic SMAT".
This transdermal patch systems are preferred at Tumor patients used against persistent pain and then continuously release fentanyl for several days. In the case of transdermal use, the liver bypassed, so that the "first pass effect" is avoided, which leads to a reduction in the effectiveness of the drug.
The transdermal patches are not suitable for short-term use in acute pain or post-operative pain.
For some time there has been Fentanyl also as Lozengewhich can then be given as an acute gift. As the fentanyl is absorbed through the oral mucosa, the fentanyl floods quickly and thereby also relieves severe pain quickly.
Side effects
As with any drug, side effects can occur with fentanyl. These are at Durogesic® often because the drug is a strong anesthetic.
The most common side effects observed are:
- Respiratory depression
- central nervous tendency to cramp
- Smooth muscle spasms in biliary tract and pancreas
- Spastic constipation
- Urinary retention
- Miosis
- Loss of appetite
- Change in taste perception
- Decrease in sex drive
- Anaphylaxis
- Acute heart failure
- Bronchospasm
- Skin reactions when applying transdermal patches ("Durogesic")
- Thoracic rigidity
When switching from other opioids to patches containing fentanyl, the affected patients often complain Withdrawal symptomsthat may need to be treated.
Interactions
Durogesic® shows with some Medication partly very dangerous interactionswhich should be strictly observed when using:
- other Opioids with weaker effects, may make fentanyl less effective
- MAOIs, through interaction the Circulatory depression of fentanyl strengthen and strong CNS side effects cause
- other drugs: preparations that act by inhibiting the Cytochrome P-450 reduce the rate of degradation of fentanyl in the liver (e.g. azoles) -> longer duration of action of fentanyl.
Contraindications
Durogesic® can worsen the following diseases and conditions and should not be prescribed in these cases:
- Diseases of the lungs
- Diseases of the intestine
- Diseases of the prostate
- Diseases of the cardiovascular system
- Myxedema
- Arrhythmias and
- pregnancy
Fentanyl subject to Narcotics Act (BtMG) and therefore all fentanyl finished medicinal products must be prescribed by the doctor using a so-called narcotic prescription.
