Oral morphine to fentanyl patch conversion

Opioids are a class of compounds that elicit analgesic (pain killing) effects in humans and animals by binding to the µ-opioid receptor within the central nervous system . The following table lists opioid and non-opioid analgesic drugs and their relative potencies . Values for the potencies represent opioids taken orally unless another route of administration is provided. As such, their bioavailabilities differ, and they may be more potent when taken intravenously . Methadone is different from most opioids considering its potency can vary depending on how long it is taken. Acute use, 1–3 days, yields a potency about × stronger than that of morphine and chronic use (7 days+) yields a potency about to 5× that of morphine due to methadone being stored in fat tissue, thus giving higher serum levels with longer use. [ citation needed ] Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use, this effect becomes less significant again with even longer use as tolerance develops. [ citation needed ]

A prospective study was carried out in a convenience sample of consecutive patients admitted to an acute palliative care unit and a home care unit for a period of 1 year. Patients who were switched from/to tapentadol were selected. The initial ratio between tapentadol and other opioids, expressed as oral morphine equivalents was 1:. The subsequent doses were flexible and were changed to fit the patients' needs. Pain intensity and distress score were recorded until opioid doses were stable. In all, 37 patients were examined; 24 and 13 patients were switched from and to tapentadol, respectively.

Fentanyl was first synthesized by Paul Janssen under the label of his relatively newly formed Janssen Pharmaceutica in 1959. [65] In the 1960s, fentanyl was introduced as an intravenous anaesthetic under the trade name of Sublimaze. [ citation needed ] In the mid-1990s, Janssen Pharmaceutica developed and introduced into clinical trials the Duragesic patch, which is a formation of an inert alcohol gel infused with select fentanyl doses, which are worn to provide constant administration of the opioid over a period of 48 to 72 hours. After a set of successful clinical trials, Duragesic fentanyl patches were introduced into medical practice.

An increased incidence of abortion was noted in a study in which pregnant rabbits were treated with ( times the HDD) to 10 mg/kg morphine sulfate via subcutaneous injection from Gestation Day 6 to 10. In a second study, decreased fetal body weights were reported following treatment of pregnant rabbits with increasing doses of morphine (10 to 50 mg/kg/day) during the pre-mating period and 50 mg/kg/day (16 times the HDD) throughout the gestation period. No overt malformations were reported in either publication; although only limited endpoints were evaluated.

Oral morphine to fentanyl patch conversion

oral morphine to fentanyl patch conversion

An increased incidence of abortion was noted in a study in which pregnant rabbits were treated with ( times the HDD) to 10 mg/kg morphine sulfate via subcutaneous injection from Gestation Day 6 to 10. In a second study, decreased fetal body weights were reported following treatment of pregnant rabbits with increasing doses of morphine (10 to 50 mg/kg/day) during the pre-mating period and 50 mg/kg/day (16 times the HDD) throughout the gestation period. No overt malformations were reported in either publication; although only limited endpoints were evaluated.

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