Fentanyl, The Miracle Drug That Killed Prince

[sportsrancho]

Jun 6, 2016 19:09:29 GMT -5 centralcoastinvestor said:

Jun 6, 2016 18:38:37 GMT -5 sportsrancho said:

www.youtube.com/watch?v=RoHBDim_fzk&sns=em

Trigger points are specific “knots” that form in muscles. They are unique and can be identified because they will refer pain. Pain referral, for our purposes, can most easily be described as the pain felt when pressure is applied to one area of the body, but the pain is felt or radiated in another area.

A common example of a trigger point is felt while foam rolling your iliotibial (IT) band as it causes pain to radiate up to the hip or all the way down the leg to the ankle. When rolling or working on tight/sore muscles you will experience discomfort or pain. Think of it like the pain you get while stretching. It should be uncomfortable, but not unbearable, and when you are done it should feel better.

Thanks to both you and Reverselo for the foam rolling info.  I will watch video and look into giving it a test drive.  I mean roll.

Also the best investment I ever made was a Tempur-Pedic memory foam bed!

[Deleted]

Jun 6, 2016 20:14:07 GMT -5 sportsrancho said:

Jun 6, 2016 19:09:29 GMT -5 centralcoastinvestor said:

Thanks to both you and Reverselo for the foam rolling info.  I will watch video and look into giving it a test drive.  I mean roll.

Also the best investment I ever made was a Tempur-Pedic memory foam bed!

An premium mattress is a must. I agree a 1000%. You spend a third of you life there. It better be quality time.

[kc]

Jun 6, 2016 17:05:37 GMT -5 @reverselo said:

Jun 6, 2016 14:07:36 GMT -5 liane said:

I don't dispute the opiod epidemic, but I will take no ownership of it. I prescribe opiods so infrequently such that I question if I should keep my DEA license ( at a cost of $770 for 3 years). But then I remember the once a year acute herniated disc that drags themself into my office and I know they will appreciate my ability to prescribe opiods after more conservative measures have failed. There is a time and a place for these drugs, though it's tragic that they have been so over-prescribed.

I don't know you personally but you can tell a lot about a person by their posts.  You seem like a no non sense type of person. I am the same way. I don't think you are one of those types of Dr's and it has to be tough as to where do you draw the line? Are they telling the truth are they lying are they really in pain? It blows my mind how often Big Pharma runs opioid enduced constipation commercials. I didnt really pay attention to it at first but then I was like wow this commercial is on all the time. Theres a ton of backed up plumbing out there because everyone is on opioids.


I am in my late 30's I have no cartilidge in my knees from years of basketball. I have two bulging discs. I have an ankle that is slightly deformed (but I can I work around it) from a misdiagnosis in the emergency room. I have very very mild arthritis in both my hips. I am still extremely active but its a chore for me at night. I have to foam roll my whole body. Dedicate one day to yoga and I have about 4-5 frozen bags of peas on my body at night while I watch TV. If I hit a certain weight things start to bother me and I am reminded why I need to do this maintenance because it would be so easy to walk into a Dr's office and get a pain killer. There are some days I wonder if I am going to be able to walk at 70 years old and if this is all worth it. Guess I will find out.....

Wow! Sorry to hear about all your ailments and hope you get better. At age 57 I guess I am lucky that I have none of this. I wish you the best and better health.

Now to Liane I didn't know you were a physician. I like your attitude of how you deal with your patients. I'm sure you're great physician.

[Deleted]

A life time of athletics has its downside. I just helped shark tank an amateur fighter on Sunday. This is where 3 different guys spar with the guy who is fighting for a total of 12 rounds. The guy who has a fight has to keep going against fresh legs. You would never know I have all these aliments. Well my wife does because she has to hear me complain at night lol

[mnholdem]

Jun 6, 2016 18:03:54 GMT -5 liane said:

Jun 6, 2016 17:05:37 GMT -5 @reverselo said:

I don't know you personally but you can tell a lot about a person by their posts.  You seem like a no non sense type of person.

Got that right!  

[liane]

Love it!!!

[sportsrancho]

Perfect!

[corpplanner]

Fentanyl already comes in a patch form which is a pulsed release. Cancer patients frequently use it in this form. Personally, I can't see an easy approval for a TS fentanyl use because it would be way too easy to misuse/abuse. There are other applications for TS technology that probably would be quicker to approval.

[cm5]

Please review Fentanyl (patches and sublingual spray) and the above Mannkind patent:

Above Mannkind patent:

Therefore, there is still a need in the medical art to develop new treatments for pain which would facilitate patient therapy and reduce or eliminate unwanted side effects. Additionally, there is a need for the identification and development of new compounds and compositions that do not cross the blood-brain barrier and effectively alleviate pain without activating opioid receptors in the central nervous system. . .

The amount of opioid receptor agonist composition can vary depending on the subject's requirements, for example, in amounts of 1 mg or greater. In example embodiments, the amount of peptide opioid receptor agonist in a dry powder for pulmonary inhalation can be administered in a range of from about 1 to about 50 mg.

Acute pain is characterized by a sudden onset and relatively short duration, and is generally treated with opioid analgesics like morphine. Morphine and similar opioid analgesics suppress the perception of pain by reducing the number of pain sensations sent by the nervous system and the brain's reaction to those pain signals. Current opioid therapy using morphine and like compounds are effective to treat pain but the side effects they produce such as addiction, somnolence, tolerance, respiratory depression, and constipation limit their clinical use.

Courtesy of Wikipedia:

Fentanyl (also known as fentanil, brand names Sublimaze,[6 Actiq, Durogesic, Duragesic, Fentora, Matrifen, Haldid, Onsolis,[7 Instanyl,[8 Abstral,Lazanda and others, is a potent, synthetic opioid analgesic with a rapid onset and short duration of action.    

It is a strong agonist at the μ-opioid receptors.

Fentanyl is approximately 80 to 100 times more potent than morphine and roughly 40 to 50 times more potent than pharmaceutical grade (100% pure) heroin.

HOW SUPPLIED/STORAGE AND HANDLING

DURAGESIC (fentanyl transdermal system) is supplied in cartons containing 5 individually
packaged systems. See chart for information regarding individual systems.
Each DURAGESIC patch may be worn continuously for 72 hours. The next patch is applied
to a different skin site after removal of the previous transdermal system.

DURAGESIC-12*   5.25 cm2    Fentanyl Content =2.1 milligrams      (12 micrograms per hour)
DURAGESIC-25    10.5 cm2     Fentanyl Content =4.2 miligrams      (25 micrograms per hour)
DURAGESIC-50     21 cm2       Fentanyl Contnet = 8.4 milligrams    (50 micrograms per hour)
DURAGESIC-75    31.5 cm2      Fentanyl Content =12.6 milligrams   (75 micrograms per hour)
DURAGESIC-100   42 cm2        Fentanyl Content = 16.8 milligrams    (100micrograms per hour)

*This lowest dosage is designated as 12 mcg/h (however, the actual dosage is 12.5 mcg/h) to distinguish it from a
125 mcg/h dosage that could be prescribed by using multiple patches.

RECOMMENDED INITIAL DURAGESIC DOSE BASED UPON DAILY ORAL
MORPHINE DOSE
Oral 24-hour
Morphine (mg/day)       Duragesic (mcg/hour)
 60--134mg                                 25
135–224                                     50
225–314                                     75
315–404                                     100
405–494                                     125
495–584                                     150
585–674                                     175
675–764                                     200
Please Note:  Can take 6 days to reach steady-state dose for pain control with change of dosage---

Subsys is a sublingual spray formulation of fentanyl. Fentanyl is an opioid agonist whose principal therapeutic action is analgesia. The precise mechanism of the analgesic action is unknown although fentanyl is known to be a mu-opioid receptor agonist.

Subsys was specifically approved for the management of breakthrough pain in adult cancer patients who are already receiving and who are tolerant to around-the-clock opioid therapy for their underlying persistent cancer pain.

Susbsys is supplied as a spray for sublingual administration. Subsys should be individually titrated to a dose that provides adequate analgesia and minimizes side effects. The initial dose of Subsys to treat episodes of breakthrough cancer pain is always 100 mcg. From this initial dose, the dose should be titrated to provide adequate analgesia using a single Subsys dose per breakthrough cancer pain episode with tolerable side effects. For each breakthrough pain episode treated, if pain is not relieved after 30 minutes, patients may take ONLY ONE additional dose of the same strength for that episode. Thus the maximum of two doses of Subsys is recommended for any breakthrough pain episode. Patients MUST wait at least 4 hours before treating another episode of breakthrough pain with Subsys.

Hazards of Fentanyl Patches: www.lawyersandsettlements.com/articles/duragesic/duragesic-fentanyl-lawsuit-patch-5-17672.htm

The Hidden Dangers of Fentanyl Patches: FDA

May 1, 2012, 08:00:00AM. By Gordon Gibb

The Hidden Dangers of Fentanyl Patches: FDAThe Duragesic patch contains fentanyl, an opioid (and classed as a narcotic) several times more potent than morphine. The product was designed to deliver ongoing pain management to patients experiencing chronic pain. The fentanyl is contained in a reservoir inside the patch. When applied, a properly functioning patch is designed to administer measured amounts of fentanyl through the skin—enough to dull intense pain, yet not enough to pose a health risk.

Previously, there have been instances where the Fentanyl Duragesic patch has been compromised due to a manufacturer's defect, putting many patients in serious jeopardy. A Duragesic patch recall was undertaken several years ago for just that reason. Caregivers need to handle the patches with care, to avoid the possibility of fentanyl getting into their system through their hands and fingers.

Fentanyl can be lethal.

Last month, the FDA issued a communiqué, warning of the dangers Fentanyl patches can pose to children. CNN Wire reported April 19 on the FDA advisory that stated, in part:

"Young children are at particular risk of accidental exposure to fentanyl patches. Their mobility and curiosity provide opportunities for them to find lost patches, take improperly discarded patches from the trash, or find improperly stored patches, all of which may result in patches being placed in their mouths or sticking to their skin. Additionally, young children are at risk of exposure when being held by someone wearing a partially detached patch, which can then transfer to the child."

Duragesic side effects can slow breathing, and even result in death. To that end, the FDA reports 10 deaths and 12 cases requiring hospitalization out of 26 incidents of accidental fentanyl exposure since 1997, the FDA says.

Those are the reported incidents. Many more go unreported, especially given the rise in illicit use of the Duragesic pain patch by non-patients.

READ MORE DURAGESIC FENTANYL PATCH LEGAL NEWS
Fentanyl Patch Kills Tot, Fentanyl Lawsuit Launched
Lawsuit Filed Against Fentanyl Patch Maker
Duragesic Fentanyl Patches Could Put Patients At Risk

The Suffolk News-Herald on March 30 referenced the overdose death of 17-year-old Briley Marie Compton the previous April. The Portsmouth, Virginia teen died from a combination of Coricidin and fentanyl, two drugs that were not prescribed to her, but allegedly given to her by her boyfriend. Her death, on April 22, 2011, was initially ruled accidental, stemming from a fall. But nearly a year after her tragic death, on March 28, William Daniel Conroy Jr. was indicted on a charge of second-degree murder.

It is not known if the Compton family has filed a fentanyl lawsuit.

While illicit use of the Duragesic pain patch is something a manufacturer can't easily control, there are plenty of instances of patients having died, or whose health has been severely compromised as the result of a defective fentanyl patch or improper use of the patch. In some cases, doctors have prescribed fentanyl for conditions not warranting such a potent opioid. In others, patients have fallen ill or have died from the use of a fentanyl patch while unaware of the consequences.

Many a Duragesic lawsuit has followed.

[corpplanner]

Thanks. I've interviewed terminally ill lung cancer patients/patients with bone mets about their pain and who would not be able to inhale, most likely. I recall specifically one guy opened up his shirt and he had 3 patches on. He said if he needs more pain relief, he rubs the patch to release a little more. Patients with chronic pain get pretty savvy, pretty quickly. And people with chronic pain rarely become addicted though they can build tolerance. It is generally the acute patient that is predisposed to addiction.

Perhaps an inhaled pain killer would be appropriate for other types of patients such as immediate post-surgical, migraine. However, for generalized pain on an acute basis, my guess is that it would be difficult to get an approval of a new inhaled product due to the potential for abuse.