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García Piqueras P, Vírseda González D, Soledad Encalada Luna K, Rodríguez Lomba E. Transdermal Fentanyl in Acute Skin Failure: Risks That Should be Closely Monitored at the Dermatology Emergency Room. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00137-6. [PMID: 38373605 DOI: 10.1016/j.ad.2023.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 04/02/2023] [Indexed: 02/21/2024] Open
Affiliation(s)
- P García Piqueras
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España.
| | - D Vírseda González
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - K Soledad Encalada Luna
- Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - E Rodríguez Lomba
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
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Sommerfeld-Klatta K, Jiers W, Łukasik-Głębocka M, Tezyk A, Dolińska-Kaczmarek K, Walter K, Świderski P, Rzepczyk S, Zielińska-Psuja B, Żaba C. Severe and Fatal Fentanyl Poisonings from Transdermal Systems after On-Skin and Ingestion Application. TOXICS 2023; 11:872. [PMID: 37888722 PMCID: PMC10610823 DOI: 10.3390/toxics11100872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
In recent years, the administration of fentanyl (FNTL) implicitly in transdermal drug delivery systems (TDDS) has vastly increased in chronic pain treatment. Non-medical and uncontrolled use of FNTL in TFDS (transdermal fentanyl delivery systems) may reveal toxic effects by the route of exposure, dermal or alternative, by ingestion of patches, and drug release in the stomach. The purpose of this study was to present three different cases of FNTL poisonings, two of which resulted in death due to TFDS abuse. The first case is a 66-year-old woman treated for accidental FTNL poisoning resulting in acute respiratory distress syndrome. Two remaining cases are a 31-year-old woman and a 25-year-old man who died as a result of FNTL overdose after on-skin and ingestion application of the drug patches. During the hospitalization of the 66-year-old patient, in blood samples, FNTL was confirmed at a concentration of 10.0 ng/mL. Tests run on blood taken from the corpses of 25- and 31-year-old patients exhibited FNTL presence in concentrations of 29.1 ng/mL and 38.7 ng/mL, respectively. The various routes of administration and ultimately toxic effects are important to present because, in TDDS, fentanyl can be a reason for severe to fatal poisoning, as shown by the three cases above.
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Affiliation(s)
- Karina Sommerfeld-Klatta
- Department of Toxicology, Poznań University of Medical Sciences, 30 Dojazd Street, 60-631 Poznan, Poland
| | - Wiktoria Jiers
- Department of Toxicology, Poznań University of Medical Sciences, 30 Dojazd Street, 60-631 Poznan, Poland
| | - Magdalena Łukasik-Głębocka
- Department of Emergency Medicine, Poznań University of Medical Sciences, 7 Rokietnicka Street, 60-806 Poznan, Poland
| | - Artur Tezyk
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Klaudia Dolińska-Kaczmarek
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Kamil Walter
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Paweł Świderski
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Szymon Rzepczyk
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
| | - Barbara Zielińska-Psuja
- Department of Toxicology, Poznań University of Medical Sciences, 30 Dojazd Street, 60-631 Poznan, Poland
| | - Czesław Żaba
- Department of Forensic Medicine, Poznań University of Medical Sciences, 10 Rokietnicka Street, 60-806 Poznan, Poland
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Tirupathi S, Afnan L. Safety Considerations of Fentanyl Transdermal Patches Used for Third Molar Surgery Pain Relief. J Maxillofac Oral Surg 2023; 22:371-372. [PMID: 37122790 PMCID: PMC10130255 DOI: 10.1007/s12663-023-01851-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Affiliation(s)
- Sunnypriyatham Tirupathi
- Department of Pediatric and Preventive Dentistry, Dr.D.Y.Patil Dental College and Hospital, Dr.D.Y.Patil Vidyapeeth, Pimpri, Pune, Maharashtra 411018 India
| | - Lamea Afnan
- Department of Public Health Dentistry, Dr.D.Y.Patil Dental College and Hospital, Dr.D.Y.Patil Vidyapeeth, Pimpri, Pune, Maharashtra 411018 India
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de Bruin-Hoegée M, de Koning MC, Cochrane L, Joosen MJ. Contact transfer risk from fentanyl-contaminated RSDL® Kit. Toxicol Lett 2020; 319:237-241. [DOI: 10.1016/j.toxlet.2019.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 11/09/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023]
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