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Fentanyl

Fentanyl. Julie Latimer DANA NSW Drug & Alcohol Nurses Forum September 2014. Sydney Medically Supervised Injecting Centre - MSIC. MSIC provides: A practical and compassionate response to drug injecting

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Fentanyl

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  1. Fentanyl Julie Latimer DANA NSW Drug & Alcohol Nurses Forum September 2014

  2. Sydney Medically Supervised Injecting Centre - MSIC MSIC provides: • A practical and compassionate response to drug injecting • Supervision of injecting episodes that might otherwise occur in less safe circumstances such as public places or alone • A safer environment where immediate medical assistance is available if required • Access to health & social welfare services for a marginalised & difficult to reach population

  3. Drugs used at MSIC

  4. What is Fentanyl? • Powerful synthetic opioid analgesic • 100 times more potent than Morphine • Highly lipid soluble = rapid onset • Transdermal patch • Prescription of fentanyl patches in Australia has increased dramatically since 2006

  5. Fentanyl at MSIC • First recorded use at MSIC Sept 2012 • Higher incidence of overdose compared to other opioids • Increase in use now that new formulation of Oxycontin (OP) available

  6. Concerns… • High incidence of overdose due to potency • Fatalities internationally & nationally • Misinformation around dosage • Complicated preparation process • Tolerance rapidly increases with regular use

  7. Some questions to ask… • Have you used Fentanyl before? • Do you know the Oxycontin equivalent of the patch you have? • How do you prepare it for injection? • How many 80mg Oxycontin tabs do you usually use? • Have you ever overdosed after using Fentanyl?

  8. Fentanyl management at MSIC • Discussion with clients regarding dose and knowledge base • Increased chance of overdose – may happen quickly • Close observations – 1st 20 mins are important • Clients report effects are not always pleasant

  9. Fentanyl:Morphine:Oxycontin equivalent

  10. MSIC patch measurement guide

  11. Key messages • Fentanyl is 100 times more potent than Morphine • Risk of overdose is much higher • 1cm square of any strength patch will have the same amount of Fentanyl on it • Find out what the client knows about Fentanyl

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