Fentanyl-containing pain relievers

At fentanyl pain relievers are some of the strongest pain relievers available in pharmacies. The active ingredient comes u. a. for use against rheumatism and cancer as well as for surgical interventions. It can be presented in various forms. He also gained notoriety in the summer of 2016 when it became known that the musician Prince died of an overdose of this drug.

What are fentanyl pain relievers?

Fentanyl is one of the most effective pain relievers (analgesics). Its effects are said to be 50 to 100 times stronger than that of morphine. The opioid requires a prescription and is only available upon presentation of a prescription. In addition, the analgesic falls under the Narcotics Act (BtMG). This means that the prescription of finished fentanyl drugs takes place exclusively via a BtM prescription.

Fentanyl was developed in 1959 by the Belgian chemist and pharmaceutical entrepreneur Paul Janssen (1926-2003). The pain reliever hit the market in the 1960s. Over time, the molecular structure of the active ingredient was modified several times, which resulted in derivatives that could be better controlled. In the 1990s, for example, a pain plaster was available that was also suitable for the treatment of chronic pain.

In the further course, fentanyl could also be administered in the form of buccal tablets, which are placed on the mucous membrane of the cheek, lollipops, nasal sprays and mouth sprays. One disadvantage of the drug, however, is that it is addictive.

Pharmacological effect

Fentanyl belongs to the group of active substances called opioids. These come from the opiates found in the poppy plant. They have the property of having an inhibiting effect on the sensation of pain. Opioids are chemical-synthetic substances whose production is based on the model of opiates. They have the same mechanism of action as the opiates. Fentanyl is one of these opioids.

When it is absorbed into the body, it can quickly cross the blood-brain barrier and binds to the opioid receptors in the brain and spinal cord, where it prevents the transmission of pain signals. In this way, the brain is no longer able to register the pain. The analgesic effect of fentanyl is so strong that even small amounts are sufficient to suppress the pain.

The medicinal substance can enter the body in different ways through a variety of dosage forms. An almost immediate effect can be obtained from an injection of fentanyl. It can also be absorbed through the mucous membrane of the mouth and nose, so that the pain-relieving effect sets in after just a few minutes. If the patient applies the fentanyl to the skin, it takes a few hours for the effects to start.

The breakdown of fentanyl takes place in the liver, where it is metabolized into ineffective breakdown products. The opioid gets out of the body through the kidneys. After about 7 hours, about 50 percent of the pain reliever is eliminated from the body. This process takes longer when taking prolonged-release tablets.

Medical application & use

Fentanyl is given to treat severe to very intense pain. In most cases, the patient is given a special patch. This releases the drug evenly over a period of several days. This treatment method is primarily used to treat cancer and is suitable for combating persistent pain.

However, the pain plasters are not suitable for acute pain or wound pain after operations. In such cases, injection solutions are given by syringe. The fentanyl is also used to induce anesthesia, which is combined with a sleeping pill.

Lozenges or nasal sprays are also given to treat acute pain, as these preparations can also take effect quickly. As a rule, the opioid is only taken for a short time in acute cases. The doctor determines the individual dose.

If chronic pain needs to be treated with a fentanyl patch, the medical staff cleans the selected skin area, which should be intact and hairless, with water. After drying, the patch is gently pressed on for about 30 seconds and remains on the skin for three days until it is replaced by another patch elsewhere. The treated area needs a break of at least a week before a fentanyl patch can be applied there again.

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Risks & side effects

There are a number of undesirable side effects at risk of taking fentanyl. These primarily include restlessness, drowsiness, headache, dizziness, skin rash, itching, sweating, constipation, nausea, vomiting, changes in mood, dry mouth, slow heartbeat, bladder emptying disorders, diarrhea, skin redness, digestive problems, confusion, anxiety disorders, Nervousness, depression and hallucinations.

Occasionally, tremors, sensitivity disorders, memory problems, low blood pressure, sleep problems, breathing disorders, palpitations, high blood pressure or speech disorders are also possible. There is also a risk that the patient will become dependent on fentanyl.

If there is hypersensitivity to fentanyl or a dependency on opioid pain relievers, the active ingredient must not be administered. The same applies to severe impairment of brain function. Careful weighing of the risks and benefits of fentanyl treatment is necessary if the patient has arrhythmias with a slow heartbeat, increased intracranial pressure, impaired consciousness, COPD or other lung diseases and impaired kidney and liver function.

Under no circumstances should fentanyl be given during pregnancy. The child is already at risk of becoming dependent in the womb. This is noticeable through withdrawal symptoms after the birth. The fentanyl can also restrict the child's breathing. Because the drug is excreted in breast milk, it should not be used while breastfeeding. In principle, however, fentanyl is also suitable for treating children.