What is Durogesic®?
Durogesic® is the trade name under which the highly potent synthetic analgesic (pain reliever) Fentanyl is marketed. Fentanyl is an analgesic with pharmacological properties very similar to morphine. However, compared to morphine, Fentanyl is a hundred times more effective.
Indications
Fentanyl is mostly used as an anesthetic in general anesthesia, during which it is usually combined with other preparations. In the treatment of very severe pain (e.g. tumor pain) Fentanyl is also used (then as a pain patch). In emergency medicine, Fentanyl is used as a standard analgesic for very severe pain (such as burns, polytraumas, etc.) due to its high potency and the immediate injection.
Pharmacokinetics
Only the pharmaceutical fentanyl dihydrogen citrate or fentanyl citrate is used, the effect of which is very rapid after intravenous administration (e.g. as a syringe) and lasts for about 30 minutes after a bolus injection of 100 micrograms of fentanyl. Fentanyl binds mainly to the μ opioid receptors, but may also show agonistic affinity to the μ and κ opioid receptors.
How is Durogesic® applied?
In anesthesia, Fentanyl is used as an injection solution. Another way of using Fentanyl is as a patch (so-called transdermal system). In this form it is then sold as “Durogesic TTS” or “Durogesic SMAT”.
These transdermal patch systems are preferred for use in tumor patients for permanent pain and then release Fentanyl continuously over several days. Transdermal application bypasses the liver, thus avoiding the “first-pass effect” that leads to a reduction in the drug’s effectiveness. The transdermal patches are not suitable for short-term use in acute or postoperative pain. For some time now, Fentanyl has also been available as a lozenge, which can then be administered as an acute dose. The absorption of Fentanyl through the oral mucosa causes Fentanyl to flood quickly, thereby quickly relieving even severe pain.
Side effects
As with any drug, Fentanyl may also cause side effects. These are common with Durogesic® because the drug is a strong anesthetic. The following side effects have been observed most frequently: When switching from other opioids to patches containing fentanyl, patients often complain of withdrawal symptoms that may need to be treated.
- Breathing Depression
- Central nervous spasm readiness
- Cramps of the smooth musculature in bile ducts and pancreas
- Spastic constipation
- Urinary retention
- Miosis
- Appetite Loss
- Change in taste perception
- Reduction of the sex drive
- Anaphylaxis
- Acute heart failure
- Bronchospasms
- Skin reactions when applying transdermal patches (“Durogesic”)
- Thoracic rigidity
