Duragesic (fentanyl Citrate)

1 NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Trade Name Name Fentanyl Duragesic citrate Peak Onset 12-22hr 6 hrs

Classification opioid analgesics

Dose 25 mcg/hr

Duration 72hr

Route patch

Time/frequency Change q 72 hrs

For IV meds, compatibility with IV drips and /or solutions N/A

2 Mechanism of action and indications (Why med ordered) Binds to opiate receptors in the CNS, altering the response to and perception of pain Pain

Nursing Implications (what to focus on) Contraindications/warnings/interactions Contraindicated in: H yper sensi tivity to fenta nyl or adhe sives

K n o w n i n t o l e r a n c e

A c u t e p a i n

3 Interactions with other patient drugs, OTC Lab value alterations caused by medicine or herbal medicines (ask patient specifically) May ↑ plasma amylase and lipase levels None for this patient Be sure to teach the patient the following about this medication I n s t r u c t p a t i e n t i n h o w a n d w h e n t o a s k f o

4 Nursing Process- Assessment (Pre-administration assessment) Assess type, location, and intensity of pain before and 24 hr after application and periodically during therapy. Monitor pain frequently during initiation of therapy and dose changes to assess need for supplementary analgesics for breakthrough pain. Assess blood pressure, pulse, and respirations before and periodically during administration. If respiratory rate is <10/min, assess level of sedation. Physical stimulation may be sufficient to prevent significant hypoventilation. Dose may need to be decreased by 25-50%. Initial drowsiness will diminish with continued use. Assess bowel function routinely. Prevent constipation with increased intake of fluids and bulk, and laxatives to minimize constipating effects. Administer stimulant laxatives routinely if opioid use exceeds 2-3 days, unless contraindicated

Assessment Why would you hold or not give this med? Patient not in pain. Respiratory rate < 10/min.

Evaluation Check after giving Decrease in severity of pain without a significant alteration in level of consciousness, respiratory status, or blood pressure